| Organization Name: | ST JOSEPH'S HOSPITAL HEALTH CENTER |
| NPI Number: | 1265462386 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL SHAFFER (VP OF FISCAL AFFAIRS, CFO) |
| Mailing Address: | 5101 West Genesee Street Camillus |
| State: | NY US |
| Postal Code: | 13031 |
| Phone Number: | 3154882979 |
| Fax Number: | 3154883499 |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 11/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |