Provider Demographics
NPI:1124051719
Name:SAINT LUKES HEALTH SYSTEM HOME CARE AND HOSPICE
Entity type:Organization
Organization Name:SAINT LUKES HEALTH SYSTEM HOME CARE AND HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-599-9226
Mailing Address - Street 1:10920 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134-4108
Mailing Address - Country:US
Mailing Address - Phone:816-532-7750
Mailing Address - Fax:816-532-7754
Practice Address - Street 1:10920 ELM AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134-4108
Practice Address - Country:US
Practice Address - Phone:816-532-7750
Practice Address - Fax:816-532-7754
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT LUKE'S HEALTH SYSTEM INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-08
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X
MO006372333600000X
KS22-446223336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147836OtherPK
MO603809401Medicaid
MO603809401Medicaid