Provider Demographics
NPI:1043973613
Name:GOOD SAMARITAN HOME HEALTH CARE LTD
Entity Type:Organization
Organization Name:GOOD SAMARITAN HOME HEALTH CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EMANUEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:NDUAGUBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, RN
Authorized Official - Phone:614-668-5000
Mailing Address - Street 1:5300 E MAIN ST STE 207
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2580
Mailing Address - Country:US
Mailing Address - Phone:614-500-4408
Mailing Address - Fax:
Practice Address - Street 1:5300 E MAIN ST STE 207
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2580
Practice Address - Country:US
Practice Address - Phone:614-500-4408
Practice Address - Fax:614-636-4920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0454294Medicaid