Provider Demographics
NPI:1154317774
Name:ST JOSEPH REGIONAL HEALTH CENTER
Entity Type:Organization
Organization Name:ST JOSEPH REGIONAL HEALTH CENTER
Other - Org Name:CHI ST JOSEPH HEALTH GRIMES HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-776-2580
Mailing Address - Street 1:210 S JUDSON ST
Mailing Address - Street 2:
Mailing Address - City:NAVASOTA
Mailing Address - State:TX
Mailing Address - Zip Code:77868-3704
Mailing Address - Country:US
Mailing Address - Phone:936-825-6585
Mailing Address - Fax:936-870-4582
Practice Address - Street 1:210 S JUDSON ST
Practice Address - Street 2:
Practice Address - City:NAVASOTA
Practice Address - State:TX
Practice Address - Zip Code:77868-3704
Practice Address - Country:US
Practice Address - Phone:936-825-6585
Practice Address - Fax:936-870-4582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
451322Medicare Oscar/Certification