Healthcare Provider Details

I. General information

NPI: 1225086028
Provider Name (Legal Business Name): ST LUKES MEDICAL CENTER LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S MILL AVE
TEMPE AZ
85281-6699
US

IV. Provider business mailing address

1500 S MILL AVE ATTN: BILLING
TEMPE AZ
85281-6699
US

V. Phone/Fax

Practice location:
  • Phone: 480-784-5500
  • Fax: 480-754-5539
Mailing address:
  • Phone: 480-784-5500
  • Fax: 480-784-5539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH0047
License Number StateAZ

VIII. Authorized Official

Name: JAMES T FLINN
Title or Position: HOSPITAL CEO
Credential:
Phone: 602-251-8116