Organization
ST. JOSEPH HOSPITAL LLC
Active
Other names
St. Joseph Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNETTA TRAYLOR (DIR LICENSE AND CERTIFICATION)
(502) 596-6063
Entity
Organization
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
(208) 799-5554
Mailing address
680 S 4TH ST, LICENSE AND CERTIFICATION, LOUSIVILLE, KY 40202
(502) 212-8481
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
09
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010005406
REGENCE OF IDAHO HOSPITAL
ID
01
—
00190
BLUE CROSS OF IDAHO
ID
05
—
002270900
—
ID
05
—
2081817
—
WA
05
—
3343407
—
WA
05
—
805015100
—
ID
Enumeration date
04/06/2006
Last updated
05/22/2025
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