MEDICARE: ST. ANTHONY'S MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	314000000X	Skilled Nursing Facility
2	310400000X	Assisted Living Facility
3	313M00000X	Nursing Facility/Intermediate Care Facility

General Provider Information

NPI Number	:	1760477434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. ANTHONY'S MEDICAL CENTER

Provider Business Mailing Address
First Line	:	12700 SOUTHFORK RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63128-3201
Country	:	US
Telephone Number	:	314-525-4745
Fax Number	:	314-525-1868

Provider Business Practice Location Address
First Line	:	12700 SOUTHFORK RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63128-3209
Country	:	US
Telephone Number	:	314-525-4745
Fax Number	:	314-525-1868

Authorized Official
Title or Position	:	MANAGER, SENIOR SERVICES
Name	:	MRS. ELEONORA SICOLA
Credential	:	RN,BSN
Telephone Number	:	314-525-4745

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	09/11/2025

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