Provider Demographics
NPI:1639253842
Name:ST LUKES MEDICAL CENTER LP
Entity Type:Organization
Organization Name:ST LUKES MEDICAL CENTER LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:FLINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-251-8116
Mailing Address - Street 1:1800 E VAN BUREN ST
Mailing Address - Street 2:ATTN: BILLING
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-3742
Mailing Address - Country:US
Mailing Address - Phone:602-251-8100
Mailing Address - Fax:602-251-8685
Practice Address - Street 1:1800 E VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-3742
Practice Address - Country:US
Practice Address - Phone:602-251-8100
Practice Address - Fax:602-251-8707
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST LUKES MEDICAL CENTER LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-24
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ495897Medicaid
AZ03S037Medicare Oscar/Certification