GOOD SAMARITAN PHYSICIAN SERVICE; NPI #1932513397

Contact Information

GOOD SAMARITAN PHYSICIAN SERVICE

850 TUCK ST
LEBANON, PA 17042-7477

Phone: 717-272-8173
Fax: 717-272-4029
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Pulmonary Disease	207RP1001X	11	Physician/Internal Medicine

Indicates primary specialty

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NPI Profile & details for GOOD SAMARITAN PHYSICIAN SERVICE

NPI # 1932513397

LBN Legal business name GOOD SAMARITAN PHYSICIAN SERVICE

Authorized official JODY BOGER - (CREDENTIALING COORDINATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/13/2014

Last updated 10/05/2016 - About 10 years ago

Identifiers

Medicaid

001864024

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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