Healthcare Provider Details

I. General information

NPI: 1245373455
Provider Name (Legal Business Name): ST. LUKE'S HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL DR
COLUMBUS NC
28722-6418
US

IV. Provider business mailing address

101 HOSPITAL DR
COLUMBUS NC
28722-6418
US

V. Phone/Fax

Practice location:
  • Phone: 828-894-0820
  • Fax: 828-894-5319
Mailing address:
  • Phone: 828-894-0820
  • Fax: 828-894-5319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH0079
License Number StateNC

VIII. Authorized Official

Name: MR. KENNETH ARTHUR SHULL
Title or Position: CEO
Credential:
Phone: 828-894-3311