Provider Demographics
NPI:1306212923
Name:SMSJ TUCSON HOLDINGS LLC
Entity Type:Organization
Organization Name:SMSJ TUCSON HOLDINGS LLC
Other - Org Name:ST. JOSEPHS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORMIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-747-2634
Mailing Address - Street 1:PO BOX 204699
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-4699
Mailing Address - Country:US
Mailing Address - Phone:469-893-2000
Mailing Address - Fax:
Practice Address - Street 1:350 N WILMOT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2602
Practice Address - Country:US
Practice Address - Phone:520-873-3000
Practice Address - Fax:520-873-5162
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMSJ TUCSON HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-18
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ03T011Medicare Oscar/Certification