Provider Demographics
NPI:1255412342
Name:ST JOSEPH'S REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:ST JOSEPH'S REGIONAL MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:-
Authorized Official - Last Name:HELLYER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:574-237-7111
Mailing Address - Street 1:837 E CEDAR ST.
Mailing Address - Street 2:PAVILLION 3 SUITE220
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-2814
Mailing Address - Country:US
Mailing Address - Phone:574-237-7750
Mailing Address - Fax:574-237-7742
Practice Address - Street 1:837 CEDAR ST
Practice Address - Street 2:PAVILLION 3 SUITE220
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-2069
Practice Address - Country:US
Practice Address - Phone:574-237-7750
Practice Address - Fax:574-237-7742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059937A261Q00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Not Answered282N00000XHospitalsGeneral Acute Care Hospital