Organization
SAINT LUKE'S SOUTH HOSPITAL, INC
Active
Parent organization
SAINT LUKE'S SOUTH HOSPITAL, INC
Other names
Saint Luke's South Retail Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAINT LUKE'S SOUTH HOSPITAL, INC
Authorized official
LAWRENCE A WAGNER RPH (PHARMACY OPERATIONS MANAGER)
(913) 317-7604
Entity
Organization
Contact information
Practice address
12330 METCALF AVE, OVERLAND PARK, KS 66213-1324
(913) 317-7604
(913) 317-7597
Mailing address
12330 METCALF AVE, OVERLAND PARK, KS 66213-1324
(913) 317-7604
(913) 317-7597
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
209147
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100332210C
—
KS
05
—
603988403
—
MO
01
—
9004128
MEDICARE PART B
KS
Enumeration date
09/26/2006
Last updated
06/08/2012
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