Organization
SAINT LUKES RADIATION THERAPY-LIBERTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY M NACHTIGAL (CFO)
(816) 932-2000
Entity
Organization
Contact information
Practice address
2529 GLENN HENDREN DR, SUITE G40, LIBERTY, MO 64068-9606
(816) 251-5630
Mailing address
901 E 104TH ST, SUITE 900, KANSAS CITY, MO 64013-3497
(816) 932-2337
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
4885
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912381005
—
MO
01
—
P01685370
RAILROAD MEDICARE
MO
Enumeration date
07/17/2015
Last updated
08/30/2016
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