Provider Demographics
NPI:1932270543
Name:SAINT JOSEPH HEALTH SYSTEM INC.
Entity Type:Organization
Organization Name:SAINT JOSEPH HEALTH SYSTEM INC.
Other - Org Name:TRI-COUNTY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO/CNO
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:606-877-3950
Mailing Address - Street 1:PO BOX 2328
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-2328
Mailing Address - Country:US
Mailing Address - Phone:606-877-3950
Mailing Address - Fax:606-877-3956
Practice Address - Street 1:740 E LAUREL RD
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-8601
Practice Address - Country:US
Practice Address - Phone:606-877-3950
Practice Address - Fax:606-877-3956
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC HEALTH INITIATIVES/SAINT JOSEPH HEALTH SYSTEM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-13
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY400028251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY404212OtherBLACK LUNG PROGRAM
KY000000316537OtherBLUE CROSS BLUE SHIELD
KY44063022Medicaid
KY1526224OtherUMWA PROGRAM
KY404212OtherBLACK LUNG PROGRAM