# SAINT JOSEPH MEDICAL FOUNDATION, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SAINT JOSEPH MEDICAL FOUNDATION, INC
- **Other names:** Saint Joseph Berea Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1912144791
- **Legal business name:** SAINT JOSEPH MEDICAL FOUNDATION, INC
- **Authorized official:** KANDI R REA (PHYSICIAN CREDENTIALING)
- **Authorized official phone:** (606) 330-3404

## Contact information

- **Practice address:** 305 ESTILL ST, 4TH FLOOR, BEREA, KY 40403-1742
- **Practice address phone:** (859) 986-2343
- **Practice address fax:** (859) 986-2344
- **Mailing address:** PO BOX 73652, CLEVELAND, OH 44193-0002
- **Mailing address phone:** (606) 330-3404
- **Mailing address fax:** (606) 330-3100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2009
- **Last updated:** 01/15/2009