Healthcare Provider Details

I. General information

NPI: 1659341725
Provider Name (Legal Business Name): ST. ANTHONY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 SE COURT AVE
PENDLETON OR
97801-3215
US

IV. Provider business mailing address

2801 ST ANTHONY WAY
PENDLETON OR
97801-3800
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-4100
  • Fax: 541-278-6564
Mailing address:
  • Phone: 541-276-5121
  • Fax: 541-278-6564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number140034
License Number StateOR

VIII. Authorized Official

Name: MR. HAROLD S GELLER
Title or Position: PRESIDENT
Credential:
Phone: 541-278-3222