Provider Demographics
NPI:1285805606
Name:ST. ANTHONY MEDICAL CENTER CARE COORDINATION
Entity type:Organization
Organization Name:ST. ANTHONY MEDICAL CENTER CARE COORDINATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COORDINATION PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COPAK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:219-663-5413
Mailing Address - Street 1:1121 S INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-8516
Mailing Address - Country:US
Mailing Address - Phone:219-663-5413
Mailing Address - Fax:219-663-5491
Practice Address - Street 1:1121 S INDIANA AVE
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8516
Practice Address - Country:US
Practice Address - Phone:219-663-5413
Practice Address - Fax:219-663-5491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)