Provider Demographics
NPI:1902870181
Name:SAINT LUKES HOSPITAL OF GARNETT INC
Entity Type:Organization
Organization Name:SAINT LUKES HOSPITAL OF GARNETT INC
Other - Org Name:HOME HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-448-3131
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:GARNETT
Mailing Address - State:KS
Mailing Address - Zip Code:66032-0309
Mailing Address - Country:US
Mailing Address - Phone:785-448-3131
Mailing Address - Fax:
Practice Address - Street 1:421 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:GARNETT
Practice Address - State:KS
Practice Address - Zip Code:66032-1334
Practice Address - Country:US
Practice Address - Phone:785-448-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT LUKES HOSPITAL OF GARNETT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-15
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH002001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100294110BMedicaid
KS100294110BMedicaid