Provider Demographics
NPI:1508807272
Name:ST. JOSEPH HOSPITAL & HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:ST. JOSEPH HOSPITAL & HEALTH CENTER, INC.
Other - Org Name:ASCENSION ST. VINCENT KOKOMO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, FACHE
Authorized Official - Phone:765-456-5300
Mailing Address - Street 1:1907 W SYCAMORE ST
Mailing Address - Street 2:P.O. BOX 9010
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46904-9010
Mailing Address - Country:US
Mailing Address - Phone:765-456-5300
Mailing Address - Fax:
Practice Address - Street 1:1907 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-4197
Practice Address - Country:US
Practice Address - Phone:765-456-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. JOSEPH HOSPITAL & HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-10
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060050102273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15T010Medicare ID - Type Unspecified
IN940590Medicare PIN