Saint Lukes South Hospital Inc

Organization Active NPI Pharmacy · Overland Park, KS

NPI 1972043271 · NPPES record last updated Dec 17, 2025

Key facts

NPI
1972043271
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
Legal business name
SAINT LUKES SOUTH HOSPITAL INC
Practice address
4061 Indian Creek Pkwy
Suite 120
Overland Park, KS 66207-4030
Phone
(913) 323-4777
Fax
(913) 323-4778
NPI assigned
Mar 6, 2017
Organization subpart
No

Authorized official

Name
Matthew Marino
Title
Cfo
Phone
(816) 347-4782

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180731001960 KS Part B Supplier - Mass Immunization (Roster Biller Only) 9931183969 Practice locations: Overland Park, KS

National Provider Directory

Tax ID family
Julie a Martin MD (5 organizations share this tax ID)

Locations

4061 Indian Creek Pkwy
#120
Overland Park, KS 66207

4061 Indian Creek Pkwy
Ste 120
Overland Park, KS 66207
Phone (913) 323-4777

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Yes
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

4061 Indian Creek Pkwy
Suite 120
Overland Park, KS 66207-4030

Mailing address

4061 Indian Creek Pkwy Ste 120
Overland Park, KS 66207-4030
Phone (913) 323-4777

Other names

  • SLS Mission Farms Pharmacy Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
FHIR URL https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4 Health Information Exchange (HIE)

Other providers in Overland Park, KS

All providers in Overland Park, KS · Pharmacy in Kansas

Sources for this page

Verify at the official NPI Registry.