Covered Entity Details

RRC390049-23 ST. LUKES HOSPITAL (Terminated) - information as of 4/28/2025 11:27:46 PM

Main Details

Name

ST. LUKES HOSPITAL

Subdivision Name

ST LUKES WEST END MED CTR ENDOSCOPY - West End Endoscopy

Type

Rural Referral Center

Rural

Yes

340B ID

RRC390049-23

Medicare Provider Number

390049

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

7/11/2019

Participating Start Date

10/1/2019

Participating Approval Date

7/31/2019

Last Recertification Date

9/13/2021

Termination Date
Termination Reason

1/1/2022
Change of covered entity type

Contacts

Authorizing Official

St. Luke's Hospital
Elizabeth Artis, Finance Director
(484) 526-4707

Primary Contact

St Luke's University Health Network
Steven J Frankenbach, Senior Director, Network Reimbursement
(484) 526-3093

Addresses

Street Address

501 CENTRONIA RD
SUITE 140
ALLENTOWN, PA 18104

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
PA	1007552510051,1007552510086	1013933175,1548293954

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
RRC390049-01	Child	RRC	ST. LUKES HOSPITAL	Allentown Campus - Radiology Ultrasound	1736 HAMILTON STREET	ALLENTOWN	PA	Terminated
RRC390049-02	Child	RRC	ST. LUKES HOSPITAL	Bethlehem Campus - HV Cardio 8th Ave Bethlehem (Dept 70512001)	1469 8th Ave	Bethlehem	PA	Terminated
RRC390049-03	Child	RRC	ST. LUKES HOSPITAL	Allentown Campus - Radiology GNRL DX Hospital	1736 HAMILTON STREET	ALLENTOWN	PA	Terminated
RRC390049-04	Child	RRC	ST. LUKES HOSPITAL	Allentown Campus - Emergency Care Unit	1736 HAMILTON STREET	ALLENTOWN	PA	Terminated
RRC390049-05	Child	RRC	ST. LUKES HOSPITAL	Allentown Campus - Sleep Lab (Dept 70420001)	240 Cetronia Road	Allentown	PA	Terminated
RRC390049-06	Child	RRC	ST. LUKES HOSPITAL	Bethlehem Campus - Heart and Vascular	1469 8th Avenue	Bethlehem	PA	Terminated
RRC390049-07	Child	RRC	ST. LUKES HOSPITAL	Bethlehem Campus - Urgent Care	153 Brodhead Road	BETHLEHEM	PA	Terminated
RRC390049-08	Child	RRC	ST. LUKES HOSPITAL	Allentown Campus - Operating Room	1736 HAMILTON STREET	ALLENTOWN	PA	Terminated
RRC390049-09	Child	RRC	ST. LUKES HOSPITAL	Allentown Campus - Urgent Care West End	501 Cetronia Road	Allentown	PA	Terminated
RRC390049-10	Child	RRC	ST. LUKES HOSPITAL	Bethlehem Campus - Pain Management Center Hospital (dept 70720001)	830 Ostrum Street	Bethlehem	PA	Terminated
RRC390049-11	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Allentown - Cancer Center	240 Cetronia Road	Allentown	PA	Terminated
RRC390049-12	Child	RRC	ST. LUKES HOSPITAL	Allentown Campus - Pain Management Center	501 CETRONIA ROAD	ALLENTOWN	PA	Terminated
RRC390049-13	Child	RRC	ST. LUKES HOSPITAL	Bethlehem - Sleep Lab (Dept 70420001)	561 E. Market Street	Bethlehem	PA	Terminated
RRC390049-14	Child	RRC	ST. LUKES HOSPITAL	Bethlehem Campus - Radiology PET Scanner	153 BRODHEAD RD	BETHLEHEM	PA	Terminated
RRC390049-15	Child	RRC	ST. LUKES HOSPITAL	Allentown Campus - Anethesiology	1736 HAMILTON STREET	ALLENTOWN	PA	Terminated
RRC390049-16	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Allentown - Radiation Oncology	240 Cetronia Road	Allentown	PA	Terminated
RRC390049-17	Child	RRC	ST. LUKES HOSPITAL	Allentown Campus - Radiology CT Scan	1736 HAMILTON STREET	ALLENTOWN	PA	Terminated
RRC390049-18	Child	RRC	ST. LUKES HOSPITAL	Allentown Campus - Ambulatory Procedure Unit	1736 HAMILTON STREET	ALLENTOWN	PA	Terminated
RRC390049-19	Child	RRC	ST. LUKES HOSPITAL	St Luke's Hospital Allentown Campus - Allentown Post Acute Anesthesia Care Unit	1716 Hamilton Street	Allentown	PA	Terminated
RRC390049-20	Child	RRC	ST. LUKES HOSPITAL	St Luke's Hospital Allentown Campus - Allentown Hospital Interventional Radiology Unit	1736 Hamilton Street	Allentown	PA	Terminated
RRC390049-21	Child	RRC	ST. LUKES HOSPITAL	St Luke's Hospital Allentown Campus - Allentown Hospital Labor and Delivery Unit	1736 Hamilton Street	Allentown	PA	Terminated
RRC390049-22	Child	RRC	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Whitehall Care Now	2402 MACARTHUR RD.	WHITEHALL	PA	Terminated
RRC390049-23	Child	RRC	ST. LUKES HOSPITAL	ST LUKES WEST END MED CTR ENDOSCOPY - West End Endoscopy	501 CENTRONIA RD	ALLENTOWN	PA	Terminated
RRC390049-24	Child	RRC	ST. LUKES HOSPITAL	Allentown Hospital - Allentown Endoscopy Unit	1736 Hamilton Street	Allentown	PA	Terminated
RRC390049-25	Child	RRC	ST. LUKES HOSPITAL	St Luke's Hospital Allentown campus - Allentown Hospital Cath Lab Unit	1736 Hamilton Street	Allentown	PA	Terminated
RRC390049-26	Child	RRC	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Hamburg Care Now	9 DAVES WAY	HAMBURG	PA	Terminated
RRC390049-27	Child	RRC	ST. LUKES HOSPITAL	ST. LUKE'S HOSPITAL BETHLEHEM - Care Now Macungie	2550 ROUTE 100	MACUNGIE	PA	Terminated
RRC390049-28	Child	RRC	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Care Now Jim Thorpe	1104 NORTH ST	JIM THORPE	PA	Terminated
RRC390049-29	Child	RRC	ST. LUKES HOSPITAL	ST LUKE'S HOSPITAL - Care Now Forks	2003 SULLIVAN TRAIL	EASTON	PA	Terminated
RRC390049-30	Child	RRC	ST. LUKES HOSPITAL	EKG/Cardiology - EKG and Diagnostic Cardiology-Allentown	1736 Hamilton Street	Allentown	PA	Terminated
RRC390049-31	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Preadmission Testing Center	421 Chew Street	Allentown	PA	Terminated
RRC390049-32	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Nuclear Medicine	421 Chew Street	Allentown	PA	Terminated
RRC390049-33	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Neurodiagnostic	421 Chew Street	Allentown	PA	Terminated
RRC390049-34	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Dialysis	421 Chew Street	Allentown	PA	Terminated
RRC390049-35	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Emergency Department	421 Chew Street	Allentown	PA	Terminated
RRC390049-36	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Lanshe Breast Center	421 Chew Street	Allentown	PA	Terminated
RRC390049-37	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Cardiology-EKG	421 Chew Street	Allentown	PA	Terminated
RRC390049-38	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Endoscopy	421 Chew Street	Allentown	PA	Terminated
RRC390049-39	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - PACU	421 Chew Street	Allentown	PA	Terminated
RRC390049-40	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - PET Scanner	421 Chew Street	Allentown	PA	Terminated
RRC390049-41	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Invasive Cardiovascular Labs	421 Chew Street	Allentown	PA	Terminated
RRC390049-42	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Anesthesiology	421 Chew Street	Allentown	PA	Terminated
RRC390049-43	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Respiratory Therapy	421 Chew Street	Allentown	PA	Terminated
RRC390049-44	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - CT Scan	421 Chew Street	Allentown	PA	Terminated
RRC390049-45	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Infusion	421 Chew Street	Allentown	PA	Terminated
RRC390049-46	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - SH Imaging-Northampton	602 B East 21st Street	Norrthampton	PA	Terminated
RRC390049-47	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Vascular Lab	421 Chew Street	Allentown	PA	Terminated
RRC390049-48	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Interventional Radiology	421 Chew Street	Allentown	PA	Terminated
RRC390049-49	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - MRI Center	421 Chew Street	Allentown	PA	Terminated
RRC390049-50	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Ultrasound	421 Chew Street	Allentown	PA	Terminated
RRC390049-51	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Ambulatory Procedure Unit	421 Chew Street	Allentown	PA	Terminated
RRC390049-52	Child	RRC	ST. LUKES HOSPITAL	Sacred Heart Hospital - Operating Room	421 Chew Street	Allentown	PA	Terminated
RRC390049-53	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Short Procedure Unit	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-54	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - MRI	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-55	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Ambulatory Procedure Unit	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-56	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Infusion	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-57	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Ultrasound	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-58	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Invasive Cardiovascular Labs	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-59	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Nuclear Medicine	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-60	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Radiology	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-61	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Respiratory Therapy	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-62	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Wound Care	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-63	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Anesthesiology	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-64	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - CT Scan	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-65	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Cardiology-EKG	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-66	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Operating Room	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-67	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Emergency Department	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-68	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - PACU	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-69	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Radiology Interventional	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-70	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Pain Management	211 North 12th Street	Lehighton	PA	Terminated
RRC390049-71	Child	RRC	ST. LUKES HOSPITAL	St. Luke's Hospital Lehighton Campus - Vascular Lab	211 North 12th Street	Lehighton	PA	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	1/1/2022 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		1/1/2022 12:00:00 AM	11/10/2021 1:27 PM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	11/10/2021 1:27 PM
Terminations	Termination Date	Update	Hospital Type Change Request		1/1/2022 12:00:00 AM	11/10/2021 1:27 PM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		1/1/2022 12:00:00 AM	11/10/2021 1:27 PM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	11/10/2021 1:27 PM
Details	Last Recertification Date	Update	Recertification	9/11/2020 7:18:40 PM	9/13/2021 10:54:09 AM	9/13/2021 10:54 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1548293954 ( )		9/11/2020 7:18 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1013933175 ( )		9/11/2020 7:18 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1013933175	9/11/2020 7:18 PM
Medicaid Billing	NPI: State	Insert	Recertification		PA	9/11/2020 7:18 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1548293954	9/11/2020 7:18 PM
Medicaid Billing	NPI: State	Insert	Recertification		PA	9/11/2020 7:18 PM
Details	Last Recertification Date	Update	Recertification		9/11/2020 7:18:40 PM	9/11/2020 7:18 PM
Details	State	Update		Approved	Active	10/1/2019 12:04 AM
Contacts	Signed By	Insert	New Registration		Artis, Elizabeth Finance Director St. Luke's Hospital 4845264707	7/31/2019 8:31 AM
Details	340B ID	Update	New Registration		RRC390049-23	7/31/2019 8:31 AM
Details	Entity Subname	Update	New Registration	ST LUKES WEST END MED CTR ENDOSCOPY	ST LUKES WEST END MED CTR ENDOSCOPY - West End Endoscopy	7/31/2019 8:31 AM
Dates	Participating Approval Date	Update	New Registration		7/31/2019 8:31:02 AM	7/31/2019 8:31 AM
Details	State	Update	New Registration	Pending	Approved	7/31/2019 8:31 AM
Dates	Signed By Date	Update	New Registration		7/15/2019 8:48:53 AM	7/31/2019 8:31 AM
Dates	Start Date	Update	New Registration		10/1/2019 12:00:00 AM	7/31/2019 8:31 AM
Addresses	Main Address	Insert	New Registration		501 CENTRONIA RD SUITE 140 ALLENTOWN, PA 18104	7/11/2019 9:16 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/11/2019 9:16 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1007552510051	7/11/2019 9:16 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		PA	7/11/2019 9:16 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/11/2019 9:16 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1007552510086	7/11/2019 9:16 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		PA	7/11/2019 9:16 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1548293954	7/11/2019 9:16 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1013933175	7/11/2019 9:16 AM
Contacts	Primary Contact	Insert	New Registration		Frankenbach, Steven J Senior Director, Network Reimbursement St Luke's University Health Network 4845263093	7/11/2019 9:16 AM
Contacts	Authorizing Official	Insert	New Registration		Artis, Elizabeth Finance Director St. Luke's Hospital 4845264707	7/11/2019 9:16 AM
Details	Last Recertification Date	Insert	New Registration			7/11/2019 9:16 AM
Details	Grant Number	Insert	New Registration			7/11/2019 9:16 AM
Details	340B ID	Insert	New Registration			7/11/2019 9:16 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/11/2019 9:16 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/11/2019 9:16 AM
Details	Medicare Provider Number	Insert	New Registration		390049	7/11/2019 9:16 AM
Details	Entity Name	Insert	New Registration		ST. LUKES HOSPITAL	7/11/2019 9:16 AM
Details	Program Code	Insert	New Registration		RRC	7/11/2019 9:16 AM
Details	Entity Subname	Insert	New Registration		ST LUKES WEST END MED CTR ENDOSCOPY	7/11/2019 9:16 AM
Dates	Participating Approval Date	Insert	New Registration			7/11/2019 9:16 AM
Details	State	Insert	New Registration		Pending	7/11/2019 9:16 AM
Dates	Registration Date	Insert	New Registration		7/11/2019 9:16:45 AM	7/11/2019 9:16 AM
Dates	Signed By Date	Insert	New Registration			7/11/2019 9:16 AM
Dates	Start Date	Insert	New Registration			7/11/2019 9:16 AM
Terminations	Termination Comments	Insert	New Registration			7/11/2019 9:16 AM
Terminations	Termination Date	Insert	New Registration			7/11/2019 9:16 AM
Terminations	Termination Effective Date	Insert	New Registration			7/11/2019 9:16 AM
Terminations	Termination Reason	Insert	New Registration			7/11/2019 9:16 AM