NPIMap

Organization Active NPI

Jewish Hospital and St Mary's Healthcare, Inc.

Doing business as Long Acting Injection Clinic

  • Community/Retail Pharmacy
  • Louisville, KY
National Provider Identifier
1801336045
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P07814 Issued in KY
Legal business name
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE, INC.
Doing business as
Long Acting Injection Clinic
Practice address
2020 Newburg Rd
Louisville, KY 40205-1803
Phone
(502) 479-4445
NPI assigned
Mar 7, 2017
Organization subpart
Yes
Parent organization
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bob Steltenpohl
Title
Vice President, Finance
Phone
(502) 587-4691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X P07814 KY Primary

Addresses

Primary practice location

2020 Newburg Rd
Louisville, KY 40205-1803

Mailing address

250 E Liberty St
5TH Floor
Louisville, KY 40202-1530
Phone (502) 569-7924

Other names 1

  • Long Acting Injection Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jewish Hospital St Mary's Healthcare Inc22 organizations share this tax ID, including this one
Part of
Jewish Hospital St Mary's Healthcare Inc

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1801336045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E LIBERTY ST",
            "address_2": "5TH FLOOR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021530",
            "telephone_number": "502-569-7924",
            "fax_number": "502-587-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 NEWBURG RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051803",
            "telephone_number": "502-479-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH HOSPITAL AND ST MARY'S HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEWISH HOSPITAL AND ST MARY'S HEALTHCARE, INC.",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "STELTENPOHL",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "VICE PRESIDENT, FINANCE",
        "authorized_official_telephone_number": "502-587-4691"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Acting Injection Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.