Provider Demographics
NPI:1508948431
Name:ST JOSEPH HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:ST JOSEPH HOSPITAL CORPORATION
Other - Org Name:ST. JOSEPH HOME HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR HOME HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:KATHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:406-883-8443
Mailing Address - Street 1:PO BOX 1010
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-1010
Mailing Address - Country:US
Mailing Address - Phone:406-883-8443
Mailing Address - Fax:406-883-8440
Practice Address - Street 1:6 13TH AVE E
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-5315
Practice Address - Country:US
Practice Address - Phone:406-883-8443
Practice Address - Fax:406-883-8440
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST JOSEPH HOSPITAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-19
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10528251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
277062Medicare Oscar/Certification