Provider Demographics
NPI:1134309800
Name:SAMSO
Entity Type:Organization
Organization Name:SAMSO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:SAEED
Authorized Official - Last Name:GHAMDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:009663-877-8290
Mailing Address - Street 1:6TH STREET
Mailing Address - Street 2:2ND FLOOR, BUIKDING 61
Mailing Address - City:DHAHRAN
Mailing Address - State:EASTERN
Mailing Address - Zip Code:31311
Mailing Address - Country:SA
Mailing Address - Phone:009663-877-8290
Mailing Address - Fax:
Practice Address - Street 1:6TH STREET
Practice Address - Street 2:2ND FLOOR, BUIKDING 61
Practice Address - City:DHAHRAN
Practice Address - State:EASTERN
Practice Address - Zip Code:31311
Practice Address - Country:SA
Practice Address - Phone:009663-877-8290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA232942282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren