# ST. MARY'S HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295856748
- **Authorized official:** ROBERT BODNAR (DIRECTOR OF PATIENT ACCOUNTS)
- **Authorized official phone:** (973) 365-3012

## Contact information

- **Practice address:** 530 MAIN AVE, PASSAIC, NJ 07055-5700
- **Practice address phone:** (973) 470-3142
- **Mailing address:** 350 BOULEVARD, PASSAIC, NJ 07055-2840
- **Mailing address phone:** (973) 365-3012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4550005 | — | NJ |