Provider Demographics
NPI:1790490563
Name:SAINT ANTHONY HOSPITAL
Entity Type:Organization
Organization Name:SAINT ANTHONY HOSPITAL
Other - Org Name:SAH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MEDAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-484-1000
Mailing Address - Street 1:2875 W. 19TH STREET
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60623-3501
Mailing Address - Country:US
Mailing Address - Phone:773-484-1000
Mailing Address - Fax:
Practice Address - Street 1:2875 W. 19TH STREET
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-3501
Practice Address - Country:US
Practice Address - Phone:773-484-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336I0012XSuppliersPharmacyInstitutional Pharmacy