Provider Demographics
NPI:1639185457
Name:SAINT LUKE'S HOSPITAL OF ALLEN COUNTY, INC
Entity Type:Organization
Organization Name:SAINT LUKE'S HOSPITAL OF ALLEN COUNTY, INC
Other - Org Name:ALLEN COUNTY REGIONAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-214-8106
Mailing Address - Street 1:3066 N KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-1951
Mailing Address - Country:US
Mailing Address - Phone:620-365-1000
Mailing Address - Fax:620-365-1032
Practice Address - Street 1:3066 N KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-1951
Practice Address - Country:US
Practice Address - Phone:620-365-1000
Practice Address - Fax:620-365-1032
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT LUKE'S HEALTH SYSTEM INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-01
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO010780807Medicaid
KS000155OtherBLUE CROSS
KS100457200AMedicaid
110916OtherBLUE CROSS PRO FEE
171373Medicare Oscar/Certification