MEDICARE: SAINT LUKES HOSPITAL OF CHILLICOTHE

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
1	251E00000X	Home Health Agency	515-9	MO

Other Identifiers

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

General Provider Information

NPI Number	:	1326083304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT LUKES HOSPITAL OF CHILLICOTHE

Provider Business Mailing Address
First Line	:	100 CENTRAL ST
Second Line	:
City	:	CHILLICOTHEE
State	:	MO
Zip	:	64601-1554
Country	:	US
Telephone Number	:	660-646-2199
Fax Number	:

Provider Business Practice Location Address
First Line	:	893 FAIRWAY DR
Second Line	:
City	:	CHILLICOTHEE
State	:	MO
Zip	:	64601-3673
Country	:	US
Telephone Number	:	660-646-2199
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KEVIN T TRIMBLE
Credential	:
Telephone Number	:	816-891-6000

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	03/07/2012

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Directions to “SAINT LUKES HOSPITAL OF CHILLICOTHE ” Practice Location

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