1275852519 NPI number — SAINT LUKES HOSPITAL OF TRENTON

Table of content: (NPI 1275852519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275852519 NPI number — SAINT LUKES HOSPITAL OF TRENTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT LUKES HOSPITAL OF TRENTON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WRIGHT MEMORIAL PHYSICIANS' GROUP
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275852519
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
189 IOWA BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TRENTON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64683-8346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
660-358-5750
Provider Business Mailing Address Fax Number:
660-358-5740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
189 IOWA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRENTON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64683-8346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-358-5750
Provider Business Practice Location Address Fax Number:
660-358-5740
Provider Enumeration Date:
05/26/2010

Additional Information

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
LES
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
660-358-5702

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD111376 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 2007018105 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 7760000B , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: MD105852 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VX0000X , with the licence number: MD111376 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 2009026346 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1235334624 . This is a "NPI" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1912930975 . This is a "NPI" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1720236193 . This is a "NPI" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1174557672 . This is a "NPI" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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