Provider Demographics
NPI:1700895711
Name:SAINT LUKES HOSPITAL OF TRENTON
Entity Type:Organization
Organization Name:SAINT LUKES HOSPITAL OF TRENTON
Other - Org Name:WRIGHT MEMORIAL PHYSICIANS GROUP
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 1:189 IOWA BLVD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683-8343
Mailing Address - Country:US
Mailing Address - Phone:660-358-5750
Mailing Address - Fax:660-358-5740
Practice Address - Street 1:189 IOWA BLVD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MO
Practice Address - Zip Code:64683-8343
Practice Address - Country:US
Practice Address - Phone:660-358-5750
Practice Address - Fax:660-358-5740
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT LUKES HOSPITAL OF TRENTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO508190006Medicaid
MO7760000BMedicare PIN
MO268637Medicare Oscar/Certification