Basic Information
| Provider Information | |||||||||
| NPI: | 1447352323 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST. JOSEPHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 180 S 3RD ST STE 202 | ||||||||
| Address2: | |||||||||
| City: | BELLEVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622201952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6182342120 | ||||||||
| FaxNumber: | 6182235922 | ||||||||
| Practice Location | |||||||||
| Address1: | 12866 TROXLER AVE | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND | ||||||||
| State: | IL | ||||||||
| PostalCode: | 62249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6186547421 | ||||||||
| FaxNumber: | 6186542012 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2006 | ||||||||
| LastUpdateDate: | 12/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | NOSACKA | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6186415468 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | Y | Hospitals | General Acute Care Hospital | Critical Access |
No ID Information.