Provider Demographics
NPI:1609144344
Name:ST LUKES METHODIST HOSPITAL
Entity Type:Organization
Organization Name:ST LUKES METHODIST HOSPITAL
Other - Org Name:UNITYPOINT AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:E
Authorized Official - Last Name:AUNAN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:319-369-7094
Mailing Address - Street 1:1026 A AVE NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5036
Mailing Address - Country:US
Mailing Address - Phone:319-369-8817
Mailing Address - Fax:
Practice Address - Street 1:600 BOYSON RD NE
Practice Address - Street 2:SUITE 2
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-7221
Practice Address - Country:US
Practice Address - Phone:319-369-7990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0670059Medicaid
IA167005Medicare Oscar/Certification