Healthcare Provider Details

I. General information

NPI: 1144412727
Provider Name (Legal Business Name): ST ANTHONY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 SOUTHGATE
PENDLETON OR
97801-3845
US

IV. Provider business mailing address

1601 SE COURT AVE
PENDLETON OR
97801-3217
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-3258
  • Fax:
Mailing address:
  • Phone: 541-276-5121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateOR

VIII. Authorized Official

Name: MR. STEVEN Z TAYLOR
Title or Position: CFO
Credential:
Phone: 541-278-3220