Provider Demographics
NPI:1033296157
Name:ST. LUKE'S QUAKERTOWN HOSPITAL
Entity Type:Organization
Organization Name:ST. LUKE'S QUAKERTOWN HOSPITAL
Other - Org Name:UPPER BUCKS EMERGENCY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LICHTENWALNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-954-3383
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:610-954-3383
Mailing Address - Fax:610-954-6500
Practice Address - Street 1:1021 PARK AVE
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1573
Practice Address - Country:US
Practice Address - Phone:215-538-4561
Practice Address - Fax:215-529-5290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100745700001Medicaid
PA079626Medicare ID - Type Unspecified