Provider Demographics
NPI:1154303337
Name:SAINT LUKES SOUTH HOSPITAL, INC.
Entity type:Organization
Organization Name:SAINT LUKES SOUTH HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-347-4782
Mailing Address - Street 1:PO BOX 503820
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-0001
Mailing Address - Country:US
Mailing Address - Phone:913-317-7000
Mailing Address - Fax:
Practice Address - Street 1:12300 METCALF AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213
Practice Address - Country:US
Practice Address - Phone:913-317-7604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH46009282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO013990007Medicaid
4810326201OtherCOMMUNITY HEALTH
MO90809016OtherBLUE CROSS
KS100332210AMedicaid
2063906OtherAETNA
19769OtherHEALTHCARE USA
354280OtherFIRST GUARD
700850OtherFAMILY HEALTH PARTNERS
KS702748OtherBLUE CROSS
KS100332210AMedicaid
MO013990007Medicaid