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Organization
ST LUKES HEALTH RESOURCES
Active
Organization
ST LUKES HEALTH RESOURCES
Active
Other names
St Lukes Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK A JOHNSON (VICE PRESIDENT)
(712) 279-3934
Entity
Organization
Contact information
Practice address
2730 PIERCE ST, SUITE 203, SIOUX CITY, IA 51104-3796
(712) 277-2030
Mailing address
2720 STONE PARK BLVD, ROOM 629, SIOUX CITY, IA 51104-3734
(712) 279-3380
(712) 279-7015
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0276311
—
IA
01
—
470000727
RR MEDICARE
—
Enumeration date
06/07/2006
Last updated
06/09/2008
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