Healthcare Provider Details

I. General information

NPI: 1982978516
Provider Name (Legal Business Name): SAINT LUKES HOSPITAL OF CHILLICOTHE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 N WASHINGTON ST
CHILLICOTHEE MO
64601-2902
US

IV. Provider business mailing address

2799 N WASHINGTON ST
CHILLICOTHEE MO
64601-2902
US

V. Phone/Fax

Practice location:
  • Phone: 660-214-8260
  • Fax: 660-214-8266
Mailing address:
  • Phone: 660-214-8260
  • Fax: 660-214-8266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number005982
License Number StateMO

VIII. Authorized Official

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