Healthcare Provider Details

I. General information

NPI: 1922078096
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: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SE COURT AVE
PENDLETON OR
97801-3217
US

IV. Provider business mailing address

1601 SE COURT AVE
PENDLETON OR
97801-3217
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-3224
  • Fax: 541-278-6564
Mailing address:
  • Phone: 541-278-3224
  • Fax: 541-278-6564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number140034
License Number StateOR

VIII. Authorized Official

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