Healthcare Provider Details

I. General information

NPI: 1952297921
Provider Name (Legal Business Name): ST LUKES HOSPITAL OF KANSAS CITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10920 ELM AVE STE G#1
KANSAS CITY MO
64134
US

IV. Provider business mailing address

10920 ELM AVE STE G#1
KANSAS CITY MO
64134
US

V. Phone/Fax

Practice location:
  • Phone: 816-986-5510
  • Fax: 816-251-5362
Mailing address:
  • Phone: 816-986-5510
  • Fax: 816-251-5362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AMY NACHTIGAL
Title or Position: VICE PRESIDENT
Credential:
Phone: 816-932-3318