Provider Demographics
NPI:1003354226
Name:SAMARITAN'S HEART, LLC
Entity Type:Organization
Organization Name:SAMARITAN'S HEART, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:REE
Authorized Official - Middle Name:
Authorized Official - Last Name:MITRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-591-2278
Mailing Address - Street 1:PO BOX 255
Mailing Address - Street 2:C/O MPI
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-0255
Mailing Address - Country:US
Mailing Address - Phone:814-591-2278
Mailing Address - Fax:
Practice Address - Street 1:83 BEAVER DR STE A
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2435
Practice Address - Country:US
Practice Address - Phone:814-591-2278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care