NPIMap

Organization Active NPI

St. Joseph Medical Center

  • Long Term Care Pharmacy
  • University Place, WA
National Provider Identifier
1952444978
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
FL00058038 Issued in WA
Legal business name
ST. JOSEPH MEDICAL CENTER
Practice address
2901 Bridgeport Way W Ste 123
University Place, WA 98466-4614
Phone
(253) 534-7033
Fax
(253) 534-7012
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Mark Rake-Marona
Title
Director of Hospice
Phone
(253) 234-7026

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X FL00058038 WA Primary

Addresses

Primary practice location

2901 Bridgeport Way W Ste 123
University Place, WA 98466-4614

Mailing address

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 534-7033

Other identifiers 2

IdentifierTypeStateIssuer
6027973MedicaidWA
4931196OtherWANABP NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Franciscan HLTH System West24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

2901 Bridgeport Way W
Ste 123
University Place, WA 98466
Phone (253) 534-7033

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952444978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-534-7033",
            "fax_number": "253-534-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 BRIDGEPORT WAY W STE 123",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664614",
            "telephone_number": "253-534-7033",
            "fax_number": "253-534-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAKE-MARONA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR OF HOSPICE",
        "authorized_official_telephone_number": "253-234-7026",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WA",
            "license": "FL00058038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6027973",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "4931196",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.