Provider Demographics
NPI:1679012710
Name:ST JOSEPH MEDICAL CENTER
Entity Type:Organization
Organization Name:ST JOSEPH MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-791-1224
Mailing Address - Street 1:8441 STATE HIGHWAY 47
Mailing Address - Street 2:SUITE 4300
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77807-3207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8441 STATE HIGHWAY 47
Practice Address - Street 2:SUITE 4300
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77807-3207
Practice Address - Country:US
Practice Address - Phone:972-791-1224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00CT42Medicare PIN