Provider Demographics
NPI:1760477434
Name:ST. ANTHONY'S MEDICAL CENTER
Entity Type:Organization
Organization Name:ST. ANTHONY'S MEDICAL CENTER
Other - Org Name:ST. ANTHONY'S SENIOR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER, SENIOR SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELEONORA
Authorized Official - Middle Name:
Authorized Official - Last Name:SICOLA
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:314-525-4745
Mailing Address - Street 1:12700 SOUTHFORK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3201
Mailing Address - Country:US
Mailing Address - Phone:314-525-4745
Mailing Address - Fax:314-525-1868
Practice Address - Street 1:12700 SOUTHFORK RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-3209
Practice Address - Country:US
Practice Address - Phone:314-525-4745
Practice Address - Fax:314-525-1868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility