Provider Demographics
NPI:1073531174
Name:SAINT LUKES HOSPITAL OF GARNETT INC
Entity type:Organization
Organization Name:SAINT LUKES HOSPITAL OF GARNETT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-880-5277
Mailing Address - Street 1:421 S MAPLE ST
Mailing Address - Street 2:#309
Mailing Address - City:GARNETT
Mailing Address - State:KS
Mailing Address - Zip Code:66032-0309
Mailing Address - Country:US
Mailing Address - Phone:785-448-3131
Mailing Address - Fax:785-448-3118
Practice Address - Street 1:421 S MAPLE ST # 309
Practice Address - Street 2:
Practice Address - City:GARNETT
Practice Address - State:KS
Practice Address - Zip Code:66032-1334
Practice Address - Country:US
Practice Address - Phone:785-448-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH002001K207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100294110CMedicaid
110439Medicare PIN