Provider Demographics
NPI:1922078096
Name:ST. ANTHONY HOSPITAL
Entity Type:Organization
Organization Name:ST. ANTHONY HOSPITAL
Other - Org Name:ST. ANTHONY DEVELOPMENT CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLENKER
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:541-278-3224
Mailing Address - Fax:541-278-6564
Practice Address - Street 1:1601 SE COURT AVE
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3217
Practice Address - Country:US
Practice Address - Phone:541-278-3224
Practice Address - Fax:541-278-6564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR140034332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0400730001Medicare NSC