Basic Information
| Provider Information | |||||||||
| NPI: | 1942378351 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAINT LUKE'S EAST HOSPITAL | ||||||||
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| OtherOrganizationName: | SAINT LUKE'S EAST-LEE'S SUMMIT | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 NE SAINT LUKES BLVD | ||||||||
| Address2: | |||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64086 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163475000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 NE SAINT LUKES BLVD | ||||||||
| Address2: | |||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64086 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163475000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2006 | ||||||||
| LastUpdateDate: | 08/01/2019 | ||||||||
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| AuthorizedOfficialLastName: | MARINO | ||||||||
| AuthorizedOfficialFirstName: | MATTHEW | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8163475000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133NN1002X | Y | 193400000X SINGLE SPECIALTY GROUP | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education |
No ID Information.