Provider Demographics
NPI:1508938473
Name:ST. LUKE'S HOSPITAL
Entity Type:Organization
Organization Name:ST. LUKE'S HOSPITAL
Other - Org Name:ST. LUKE'S EASTON HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LICHTENWALNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-954-3383
Mailing Address - Street 1:414 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3516
Mailing Address - Country:US
Mailing Address - Phone:610-559-2175
Mailing Address - Fax:610-559-2195
Practice Address - Street 1:414 NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3516
Practice Address - Country:US
Practice Address - Phone:610-559-2175
Practice Address - Fax:610-559-2195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007552510051Medicaid
PA067434Medicare ID - Type Unspecified