Provider Demographics
NPI:1275060485
Name:HEMATOLOGY & ONCOLOGY ASSOCIATES AT ST. LUKE'S, LLC
Entity Type:Organization
Organization Name:HEMATOLOGY & ONCOLOGY ASSOCIATES AT ST. LUKE'S, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-205-6301
Mailing Address - Street 1:121 SAINT LUKES CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3518
Mailing Address - Country:US
Mailing Address - Phone:636-685-7804
Mailing Address - Fax:314-576-2344
Practice Address - Street 1:232 S WOODS MILL RD STE 110E
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017
Practice Address - Country:US
Practice Address - Phone:314-542-4998
Practice Address - Fax:314-542-4739
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. LUKES MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-18
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty