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DSH260138U ST. LUKE'S HOSPITAL OF KANSAS CITY (Terminated)
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Main Details
Name
ST. LUKE'S HOSPITAL OF KANSAS CITY
Subdivision Name
Saint Luke's Hospital Koontz Center for Advanced Breast Cancer
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260138U
Medicare Provider Number
260138
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/24/2017
Last Recertification Date
9/1/2022
Termination Date
Termination Reason
10/1/2023
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Saint Luke's Hospital of Kansas City
Amy Nachtigal, VP Finance
(816) 932-3318
Primary Contact
Saint Luke's Hospital
Jeff Little, Director of Pharmacy
(816) 932-2408
Addresses
Street Address
4321 Washington St.
Suite 4100
Kansas City, MO 64111
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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