Healthcare Provider Details

I. General information

NPI: 1881638203
Provider Name (Legal Business Name): SAINT LUKES HOSPITAL OF CHILLICOTHE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 N WASHINGTON
CHILLICOTHEE MO
64601-2902
US

IV. Provider business mailing address

2799 N WASHINGTON
CHILLICOTHEE MO
64601-2902
US

V. Phone/Fax

Practice location:
  • Phone: 660-646-1480
  • Fax:
Mailing address:
  • Phone: 660-646-1480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: ERIN PARDE
Title or Position: CFO
Credential:
Phone: 816-880-5277