Provider Demographics
NPI:1659533172
Name:ST LUKES QUAKERTOWN HOSPITAL
Entity Type:Organization
Organization Name:ST LUKES QUAKERTOWN HOSPITAL
Other - Org Name:ST LUKES QUAKERTOWN OUT-PATIENT NUTRITION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP PATIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:215-529-5274
Mailing Address - Street 1:1021 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1573
Mailing Address - Country:US
Mailing Address - Phone:215-538-4598
Mailing Address - Fax:215-529-5274
Practice Address - Street 1:1021 PARK AVE
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1573
Practice Address - Country:US
Practice Address - Phone:215-538-4598
Practice Address - Fax:215-529-5274
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST LUKES QUAKERTOWN HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty