Provider Demographics
NPI:1962877514
Name:SAINT LUKE'S HOSPITAL OF TRENTON
Entity type:Organization
Organization Name:SAINT LUKE'S HOSPITAL OF TRENTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
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 1:191 IOWA BLVD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683-8343
Mailing Address - Country:US
Mailing Address - Phone:660-358-5700
Mailing Address - Fax:
Practice Address - Street 1:400 N FULLERTON ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MO
Practice Address - Zip Code:64673-1418
Practice Address - Country:US
Practice Address - Phone:660-748-4042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT LUKE'S HOSPITAL OF TRENTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-08
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO268713Medicare Oscar/Certification
MO7760000BMedicare PIN