Healthcare Provider Details

I. General information

NPI: 1689954836
Provider Name (Legal Business Name): ST ANTHONY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SE COURT PL STE 114
PENDLETON OR
97801-3281
US

IV. Provider business mailing address

1600 SE COURT PL STE 114
PENDLETON OR
97801-3281
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-0571
  • Fax: 541-966-0574
Mailing address:
  • Phone: 541-966-0571
  • Fax: 541-966-0574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JIM SCHLENKAR
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 541-278-3220