Healthcare Provider Details

I. General information

NPI: 1669606737
Provider Name (Legal Business Name): SAINT LUKE'S SOUTH HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2009
Last Update Date: 09/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12300 METCALF AVE
OVERLAND PARK KS
66213-1324
US

IV. Provider business mailing address

12300 METCALF AVE
OVERLAND PARK KS
66213-1324
US

V. Phone/Fax

Practice location:
  • Phone: 913-317-7000
  • Fax:
Mailing address:
  • Phone: 913-317-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: AMY NACHTIGAL
Title or Position: CFO
Credential:
Phone: 913-317-7000