Provider Demographics
NPI:1962477604
Name:SAINT JOSEPHS HOSPITAL INC
Entity Type:Organization
Organization Name:SAINT JOSEPHS HOSPITAL INC
Other - Org Name:SAINT JOSEPH'S HOSPITAL TRANSITIONAL CARE UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-819-5294
Mailing Address - Street 1:5353 REYNOLDS ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6015
Mailing Address - Country:US
Mailing Address - Phone:912-819-5290
Mailing Address - Fax:912-819-5295
Practice Address - Street 1:11705 MERCY BLVD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1711
Practice Address - Country:US
Practice Address - Phone:912-819-2404
Practice Address - Fax:912-819-2188
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. JOSEPH'S/CANDLER HEALTH SYSTEM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-17
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-025-1500314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00851243AMedicaid
GA00851243AMedicaid