Basic Information
| Provider Information | |||||||||
| NPI: | 1659662450 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SAINT JOSEPH HEALTH SYSTEM, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BATH FAMILY HEALTH SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 910 | ||||||||
| Address2: | |||||||||
| City: | MARTIN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 416490910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592764429 | ||||||||
| FaxNumber: | 8592765939 | ||||||||
| Practice Location | |||||||||
| Address1: | 44 WATER ST | ||||||||
| Address2: | |||||||||
| City: | OWINGSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6066749776 | ||||||||
| FaxNumber: | 6066749708 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2011 | ||||||||
| LastUpdateDate: | 06/29/2015 | ||||||||
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| AuthorizedOfficialLastName: | JONES | ||||||||
| AuthorizedOfficialFirstName: | CARMEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO/VP FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 6063306015 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | KY | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.