Provider Demographics
NPI:1508085127
Name:ST. ANTHONY HOSPITAL
Entity Type:Organization
Organization Name:ST. ANTHONY HOSPITAL
Other - Org Name:ST. ANTHONY HOSPITAL URGENT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-278-3220
Mailing Address - Street 1:1601 SE COURT AVE
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-3217
Mailing Address - Country:US
Mailing Address - Phone:541-276-5121
Mailing Address - Fax:541-278-3681
Practice Address - Street 1:1514 SE COURT AVE
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3216
Practice Address - Country:US
Practice Address - Phone:541-276-5121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR140034282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR054598Medicaid
OR054598Medicaid