Provider Demographics
NPI:1174663314
Name:ST JOSEPH HEALTH SERVICES INC
Entity Type:Organization
Organization Name:ST JOSEPH HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-397-7625
Mailing Address - Street 1:2135 NOLL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-7602
Mailing Address - Country:US
Mailing Address - Phone:717-397-7625
Mailing Address - Fax:717-397-6057
Practice Address - Street 1:2135 NOLL DR
Practice Address - Street 2:SUITE C
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-7602
Practice Address - Country:US
Practice Address - Phone:717-397-7625
Practice Address - Fax:717-397-6057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010687660001Medicaid