Healthcare Provider Details
I. General information
NPI: 1437191095
Provider Name (Legal Business Name): SAINT LUKES HOSPITAL OF CHILLICOTHE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2006
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2791 N WASHINGTON ST
CHILLICOTHEE MO
64601-2902
US
IV. Provider business mailing address
2791 N WASHINGTON ST
CHILLICOTHEE MO
64601-2902
US
V. Phone/Fax
- Phone: 660-646-2682
- Fax:
- Phone: 660-646-2682
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIN
PARDE
Title or Position: CFO
Credential:
Phone: 816-880-5277