Provider Demographics
NPI:1437155595
Name:ST. LUKE'S WARREN HOSPITAL, INC.
Entity Type:Organization
Organization Name:ST. LUKE'S WARREN HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-859-2077
Mailing Address - Street 1:185 ROSEBERRY ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1690
Mailing Address - Country:US
Mailing Address - Phone:908-859-6700
Mailing Address - Fax:908-859-6853
Practice Address - Street 1:185 ROSEBERRY ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1690
Practice Address - Country:US
Practice Address - Phone:908-859-6700
Practice Address - Fax:908-859-6853
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WARREN HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-23
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ12102273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0220591Medicaid
NJ0220591Medicaid