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NPI Code Detail

MEDICARE: ST. LUKE'S METHODIST HOSPITAL, INC.

MEDICARE: ST. LUKE'S METHODIST HOSPITAL, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital6341IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164630893
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. LUKE'S METHODIST HOSPITAL, INC.
Provider Business Mailing Address
First Line : 1201 3RD AVE SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-4009
Country : US
Telephone Number : 319-369-7065
Fax Number : 319-368-5961
Provider Business Practice Location Address
First Line : 1201 3RD AVE SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-4009
Country : US
Telephone Number : 319-369-7065
Fax Number : 319-368-5961
Authorized Official
Title or Position : DIRECTOR
Name : MS. JANET M ERVIN
Credential :
Telephone Number : 319-369-8080
Provider Enumeration Date : 05/18/2007
Last Update Date : 08/22/2020

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