Provider Demographics
NPI:1497050470
Name:ST LUKES HOSPITAL-ANDERSON CAMPUS
Entity Type:Organization
Organization Name:ST LUKES HOSPITAL-ANDERSON CAMPUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP FINANCE/CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-526-3001
Mailing Address - Street 1:1872 ST LUKES BLVD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5669
Mailing Address - Country:US
Mailing Address - Phone:484-503-3000
Mailing Address - Fax:
Practice Address - Street 1:1872 ST LUKES BLVD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5669
Practice Address - Country:US
Practice Address - Phone:484-503-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QI0500X, 273R00000X, 282N00000X
PA22800101282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028092900001Medicaid
PA390326Medicare Oscar/Certification