Provider Demographics
NPI:1366486797
Name:SAINT LUKES CUSHING HOSPITAL INC
Entity Type:Organization
Organization Name:SAINT LUKES CUSHING HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-880-5277
Mailing Address - Street 1:711 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-3235
Mailing Address - Country:US
Mailing Address - Phone:913-684-1100
Mailing Address - Fax:
Practice Address - Street 1:711 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-3235
Practice Address - Country:US
Practice Address - Phone:913-684-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS052-001282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100088000AMedicaid
MO90073017OtherKC BLUE CROSS
KS000008OtherBLUE CROSS
KS100088000AMedicaid