1275926198 NPI number — ST. LUKE'S HOSPITAL OF KANSAS CITY

Table of content: (NPI 1275926198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275926198 NPI number — ST. LUKE'S HOSPITAL OF KANSAS CITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. LUKE'S HOSPITAL OF KANSAS CITY
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:
SAINT LUKE'S HOSPITAL INFUSION CENTER AT LIBERTY
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:
1275926198
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2529 GLENN HENDREN DR
Provider Second Line Business Mailing Address:
SUITE G30
Provider Business Mailing Address City Name:
LIBERTY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64068-9607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-454-1658
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2529 GLENN HENDREN DR
Provider Second Line Business Practice Location Address:
SUITE G30
Provider Business Practice Location Address City Name:
LIBERTY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64068-9607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-454-1658
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/17/2015

Additional Information

Authorized Official

Authorized Official Last Name:
NACHTIGAL
Authorized Official First Name:
AMY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
816-932-2000

Provider Taxonomy Codes

  • Taxonomy code: 261QI0500X , with the licence number:  87-57 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 87-57 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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