Healthcare Provider Details

I. General information

NPI: 1356354567
Provider Name (Legal Business Name): ST LUKE'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 08/24/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 NORTH 12TH STREET
LEHIGHTON PA
18235-1138
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 610-377-1300
  • Fax: 610-377-7618
Mailing address:
  • Phone: 484-526-4000
  • Fax: 610-377-4758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number920090
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number070501
License Number StatePA

VIII. Authorized Official

Name: THOMAS LICHTENWALNER
Title or Position: SENIOR VP FINANCE
Credential:
Phone: 484-526-3383