Healthcare Provider Details

I. General information

NPI: 1679610638
Provider Name (Legal Business Name): ST. LUKE HOSPITALS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7380 TURFWAY RD
FLORENCE KY
41042-1355
US

IV. Provider business mailing address

3200 BURNET AVE 1 RIDGEWAY
CINCINNATI OH
45229-3019
US

V. Phone/Fax

Practice location:
  • Phone: 859-212-5220
  • Fax: 859-572-5221
Mailing address:
  • Phone: 513-585-9009
  • Fax: 513-585-9373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: KYLE TAYLOR
Title or Position: VP OF FINANCIAL SERVICES
Credential:
Phone: 513-585-8494