Healthcare Provider Details

I. General information

NPI: 1841473022
Provider Name (Legal Business Name): ST. LUKES EPISCOPAL-PRESBYTERIAN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 02/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14701 OLIVE BLVD
CHESTERFIELD MO
63017-2221
US

IV. Provider business mailing address

232 S WOODS MILL RD
CHESTERFIELD MO
63017-3417
US

V. Phone/Fax

Practice location:
  • Phone: 314-542-3300
  • Fax: 314-542-3352
Mailing address:
  • Phone: 314-434-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number033636
License Number StateMO

VIII. Authorized Official

Name: MR. SCOTT H. JOHNSON
Title or Position: VICE PRESIDENT FINANCE / CFO
Credential:
Phone: 314-434-1500