Provider Demographics
NPI:1861503476
Name:ST. LUKE HOSPITAL, INC.
Entity Type:Organization
Organization Name:ST. LUKE HOSPITAL, INC.
Other - Org Name:PULMONARY SPECIALISTS OF N. KY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-585-8494
Mailing Address - Street 1:3200 BURNET AVE
Mailing Address - Street 2:1 RIDGEWAY
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3019
Mailing Address - Country:US
Mailing Address - Phone:513-585-9009
Mailing Address - Fax:513-585-9373
Practice Address - Street 1:7388 TURFWAY RD
Practice Address - Street 2:SU. 206
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1381
Practice Address - Country:US
Practice Address - Phone:859-212-4893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65915621Medicaid
OH2523200Medicaid
OH2523200Medicaid