Healthcare Provider Details

I. General information

NPI: 1760477434
Provider Name (Legal Business Name): ST. ANTHONY'S MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12700 SOUTHFORK RD
SAINT LOUIS MO
63128-3209
US

IV. Provider business mailing address

12700 SOUTHFORK RD
SAINT LOUIS MO
63128-3201
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-4745
  • Fax: 314-525-1868
Mailing address:
  • Phone: 314-525-4745
  • Fax: 314-525-1868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELEONORA SICOLA
Title or Position: MANAGER, SENIOR SERVICES
Credential: RN,BSN
Phone: 314-525-4745