Organization
SAINT JOSEPH MEDICAL FOUNDATION, INC
Active
Parent organization
SAINT JOSEPH MEDICAL FOUNDATION, INC
Other names
Saint Joseph Primary Care Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAINT JOSEPH MEDICAL FOUNDATION, INC
Authorized official
KANDI R REA (CREDENTIALING SPECIALIST)
(606) 330-3404
Entity
Organization
Contact information
Practice address
200 RICE ST, WILMORE, KY 40390-1359
(859) 858-9355
(859) 858-0416
Mailing address
PO BOX 73652, CLEVELAND, OH 44193-0002
(606) 330-3404
(606) 330-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100087490
—
KY
Enumeration date
02/16/2010
Last updated
08/04/2010
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