Provider Demographics
NPI:1558812594
Name:ST LUKES HOSPITAL CAH
Entity Type:Organization
Organization Name:ST LUKES HOSPITAL CAH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BEVERLY
Authorized Official - Last Name:BROSS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-894-0869
Mailing Address - Street 1:101 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-6418
Mailing Address - Country:US
Mailing Address - Phone:828-894-3311
Mailing Address - Fax:
Practice Address - Street 1:101 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-6418
Practice Address - Country:US
Practice Address - Phone:828-894-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0079282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
1871776914OtherBCBS
NC1245373455Medicaid
NC1760526586OtherBCBS
NC1760526586Medicaid
NC1306035829Medicaid
NC1316136328OtherBCBS
NC1427191477OtherBCBS
NC1427191477Medicaid
NC1144419052OtherBCBS
SC1245373455Medicaid
NC1497944912Medicaid
SC1760526586Medicaid
SC1497944912Medicaid
NC1245373455OtherBCBS
SC1306035829Medicaid
SC1427191477Medicaid
NC1760526586Medicare UPIN
NC1306035829Medicaid
NC1427191477Medicaid
NC1316136328Medicare PIN
SC1760526586Medicaid
NC1760526586Medicaid