Provider Demographics
NPI:1225086028
Name:ST LUKES MEDICAL CENTER LP
Entity Type:Organization
Organization Name:ST LUKES MEDICAL CENTER LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:FLINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-251-8116
Mailing Address - Street 1:1500 S MILL AVE
Mailing Address - Street 2:ATTN: BILLING
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6699
Mailing Address - Country:US
Mailing Address - Phone:480-784-5500
Mailing Address - Fax:480-784-5539
Practice Address - Street 1:1500 S MILL AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-6699
Practice Address - Country:US
Practice Address - Phone:480-784-5500
Practice Address - Fax:480-754-5539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH0047282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ494930Medicaid
AZAZ02060690OtherBLUE CROSS
AZF01182OtherPHP PHOENIX HEALTH PLAN
AZ1Z0030OtherHEALTHNET
AZ1Z0030OtherHEALTHNET
AZ030037Medicare Oscar/Certification
AZF01182OtherPHP PHOENIX HEALTH PLAN