Healthcare Provider Details

I. General information

NPI: 1972043271
Provider Name (Legal Business Name): SAINT LUKES SOUTH HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4061 INDIAN CREEK PKWY SUITE 120
OVERLAND PARK KS
66207-4030
US

IV. Provider business mailing address

4061 INDIAN CREEK PKWY STE 120
OVERLAND PARK KS
66207-4030
US

V. Phone/Fax

Practice location:
  • Phone: 913-323-4777
  • Fax: 913-323-4778
Mailing address:
  • Phone: 913-323-4777
  • Fax: 913-323-4778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW MARINO
Title or Position: CFO
Credential:
Phone: 816-347-4782