Healthcare Provider Details

I. General information

NPI: 1740411800
Provider Name (Legal Business Name): ST ANTHONY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 SE COURT AVE
PENDLETON OR
97801-3216
US

IV. Provider business mailing address

1514 SE COURT AVE
PENDLETON OR
97801-3216
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-5121
  • Fax: 541-278-3227
Mailing address:
  • Phone: 541-276-5121
  • Fax: 541-278-3227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JIM SCHLENKER
Title or Position: CFO
Credential:
Phone: 541-278-3220