Provider Demographics
NPI:1932390218
Name:SAINT JOSEPH HEALTH SYSTEM, INC
Entity Type:Organization
Organization Name:SAINT JOSEPH HEALTH SYSTEM, INC
Other - Org Name:CHI SAINT JOSPEH BEREA SNF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBELRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-313-4120
Mailing Address - Street 1:305 ESTILL ST
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-1742
Mailing Address - Country:US
Mailing Address - Phone:859-986-3151
Mailing Address - Fax:
Practice Address - Street 1:305 ESTILL ST
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1742
Practice Address - Country:US
Practice Address - Phone:859-986-3151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT JOSEPH HEALTH SYSTEM, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-05
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6000079275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18Z329Medicare Oscar/Certification