Healthcare Provider Details

I. General information

NPI: 1336317494
Provider Name (Legal Business Name): SAINT LUKE'S HOSPITAL PHYSICIAN BILLING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 02/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WORNALL RD SUITE 240
KANSAS CITY MO
64111-5941
US

IV. Provider business mailing address

PO BOX 504407
SAINT LOUIS MO
63150-0001
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-7900
  • Fax: 816-932-7920
Mailing address:
  • Phone: 816-932-7940
  • Fax: 816-932-7957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMA JOHNSON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 816-932-2589