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Contact Information

GOOD SAMARITAN HOSPITAL
611 E MAIN ST
SUITE 110
PETERSBURG, IN47567-1267
 Phone: 812-354-8785
 Fax: 812-354-8786
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Addiction (Substance Use Disorder)

101YA0400X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Counselor

101Y00000X
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for GOOD SAMARITAN HOSPITAL

NPI Number 1952309528
LBN Legal business name GOOD SAMARITAN HOSPITAL
Authorized official JOHN MANNING - (VP BEHAVIORAL HEALTH/SPEC PROJECTS)
Entity Organization
Organization subpart 1 Yes
Enumeration date 07/08/2005
Last updated 06/03/2015 - About 11 years ago
Identifiers
IN License # 4030
IN License # 4030CMHC
IN Medicaid 100270140C
IN Medicaid 100270140G
IN Other 000000574039 ANTHEM PIN FOR THIS LOCATION
IN Other 192466000 MAGELLAN
IN Other 165526 MHN GROUP
IN Other 301936 VALUE OPTIONS FACILITY
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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