Provider Demographics
NPI:1740220458
Name:SAINT JOSEPH HOSPITAL, INC
Entity Type:Organization
Organization Name:SAINT JOSEPH HOSPITAL, INC
Other - Org Name:SR JOANNA BRUNER FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMESON
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-812-4940
Mailing Address - Street 1:500 ELDORADO BLVD
Mailing Address - Street 2:BLDG 6 STE 6250
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021
Mailing Address - Country:US
Mailing Address - Phone:855-851-4127
Mailing Address - Fax:303-272-0390
Practice Address - Street 1:1960 N OGDEN ST STE 460
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3670
Practice Address - Country:US
Practice Address - Phone:303-318-2500
Practice Address - Fax:303-318-2575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-08
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04430088Medicaid
CO04430088Medicaid