Provider Demographics
NPI:1205076734
Name:COLUMBIA ST JOSEPH'S HEALTHCARE SYSTEM LP
Entity type:Organization
Organization Name:COLUMBIA ST JOSEPH'S HEALTHCARE SYSTEM LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:JULIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-424-4057
Mailing Address - Street 1:600 18TH ST
Mailing Address - Street 2:SUITE 606
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3231
Mailing Address - Country:US
Mailing Address - Phone:304-424-4730
Mailing Address - Fax:304-424-4731
Practice Address - Street 1:600 18TH ST
Practice Address - Street 2:SUITE 606
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3231
Practice Address - Country:US
Practice Address - Phone:304-424-4730
Practice Address - Fax:304-424-4731
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST JOSEPH'S HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-24
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty