Provider Demographics
NPI:1831618560
Name:ST. LUKE'S HOSPITAL MONROE CAMPUS
Entity type:Organization
Organization Name:ST. LUKE'S HOSPITAL MONROE CAMPUS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:LICHTENWALNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-526-3301
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:272-212-0420
Mailing Address - Fax:272-212-0422
Practice Address - Street 1:111 ROUTE 715
Practice Address - Street 2:
Practice Address - City:BRODHEADSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18322-7101
Practice Address - Country:US
Practice Address - Phone:272-212-0420
Practice Address - Fax:272-212-0422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty