Provider Demographics
NPI:1316158793
Name:ST. JOSEPH'S HOSPITAL
Entity type:Organization
Organization Name:ST. JOSEPH'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:URBISTONDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:044-501-5025
Mailing Address - Street 1:5665 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1701
Mailing Address - Country:US
Mailing Address - Phone:404-851-7109
Mailing Address - Fax:404-851-5657
Practice Address - Street 1:5665 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1701
Practice Address - Country:US
Practice Address - Phone:404-851-7109
Practice Address - Fax:404-851-5657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHH005132282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access