Provider Demographics
NPI:1851520399
Name:SAINT JOSEPH HEALTH INC
Entity Type:Organization
Organization Name:SAINT JOSEPH HEALTH INC
Other - Org Name:BETSY LAYNE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:STUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-285-6602
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:KY
Mailing Address - Zip Code:41649-0910
Mailing Address - Country:US
Mailing Address - Phone:606-452-4636
Mailing Address - Fax:606-452-3635
Practice Address - Street 1:9350 US HIGHWAY 23 SOUTH SUITE 3
Practice Address - Street 2:
Practice Address - City:STANVILLE
Practice Address - State:KY
Practice Address - Zip Code:41659
Practice Address - Country:US
Practice Address - Phone:606-478-3636
Practice Address - Fax:606-478-3635
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT JOSEPH HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-06
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100106230Medicaid
KY7100106230Medicaid