Provider Demographics
NPI:1093922890
Name:GOOD SAMIRTAN REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:GOOD SAMIRTAN REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH CARE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-768-6794
Mailing Address - Street 1:3509 NW SAMARITAN DR
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3766
Mailing Address - Country:US
Mailing Address - Phone:541-768-6794
Mailing Address - Fax:541-768-5278
Practice Address - Street 1:3509 NW SAMARITAN DR
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3766
Practice Address - Country:US
Practice Address - Phone:541-768-6794
Practice Address - Fax:541-768-5278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital