Organization
ST JOSEPH HOSPITAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY TEAGUE (VICE PRESIDENT, CORPORATE SECRETARY)
(629) 253-5121
Entity
Organization
Contact information
Practice address
341 SAINT JOHNS WAY, LEWISTON, ID 83501-2436
(615) 844-9800
(615) 844-9883
Mailing address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(629) 253-5121
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043744287
—
WA
Enumeration date
04/14/2017
Last updated
02/07/2023
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