Provider Demographics
NPI:1114222973
Name:ST JOSEPH MEDICAL FOUNDATION, INC.
Entity Type:Organization
Organization Name:ST JOSEPH MEDICAL FOUNDATION, INC.
Other - Org Name:ST JOSEPH HEMATOLOGY ONCOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:COO/VP FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-330-6015
Mailing Address - Street 1:PO BOX 73652
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0002
Mailing Address - Country:US
Mailing Address - Phone:859-276-6611
Mailing Address - Fax:859-276-5939
Practice Address - Street 1:701 BOB O LINK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3759
Practice Address - Country:US
Practice Address - Phone:859-224-3194
Practice Address - Fax:859-219-3304
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST JOSEPH MEDICAL FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-25
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty