# SAINT LUKES RADIATION THERAPY-LIBERTY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912381005
- **Authorized official:** AMY M NACHTIGAL (CFO)
- **Authorized official phone:** (816) 932-2000

## Contact information

- **Practice address:** 2529 GLENN HENDREN DR, SUITE G40, LIBERTY, MO 64068-9606
- **Practice address phone:** (816) 251-5630
- **Mailing address:** 901 E 104TH ST, SUITE 900, KANSAS CITY, MO 64013-3497
- **Mailing address phone:** (816) 932-2337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0203X | Radiation Oncology Clinic/Center | 4885 | MO | Yes |

## Other

- **Enumeration date:** 07/17/2015
- **Last updated:** 08/30/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1912381005 | — | MO |
| 01 | — | P01685370 | RAILROAD MEDICARE | MO |