Provider Demographics
NPI:1063682276
Name:SAMARITAN PACIFIC HEALTH SERVICES
Entity Type:Organization
Organization Name:SAMARITAN PACIFIC HEALTH SERVICES
Other - Org Name:SAMARITAN MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:BIGELOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-574-1801
Mailing Address - Street 1:815 NW 9TH STREET
Mailing Address - Street 2:SUITE 259
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-6173
Mailing Address - Country:US
Mailing Address - Phone:541-768-6768
Mailing Address - Fax:541-768-6774
Practice Address - Street 1:121 NE HARNEY STREET
Practice Address - Street 2:SUITE A
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-2524
Practice Address - Country:US
Practice Address - Phone:541-574-4797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies