1588151674 NPI number — SAINT LUKE'S NEIGHBORHOOD CLINICS, LLC

Table of content: (NPI 1588151674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588151674 NPI number — SAINT LUKE'S NEIGHBORHOOD CLINICS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT LUKE'S NEIGHBORHOOD CLINICS, LLC
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 URGENT CARE - MISSION FARMS
Provider Other Organization Name Type Code:
5
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:
1588151674
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/25/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 E 104TH ST FL 9
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64131-4517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-502-8782
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8880 NE 82ND TER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64158-1313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-502-8782
Provider Business Practice Location Address Fax Number:
816-407-9601
Provider Enumeration Date:
04/16/2018

Additional Information

Authorized Official

Authorized Official Last Name:
ROBB
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
V
Authorized Official Title or Position:
SR VP CFO SLHS
Authorized Official Telephone Number:
816-932-3729

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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