Provider Demographics
NPI:1144227646
Name:SAMARITAN HEALTHCARE & HOSPICE INC
Entity Type:Organization
Organization Name:SAMARITAN HEALTHCARE & HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:IVINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:856-596-1600
Mailing Address - Street 1:5 EVES DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3101
Mailing Address - Country:US
Mailing Address - Phone:856-596-1600
Mailing Address - Fax:856-552-2224
Practice Address - Street 1:5 EVES DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3101
Practice Address - Country:US
Practice Address - Phone:856-596-1600
Practice Address - Fax:856-552-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22819251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0097501Medicaid
NJ311504Medicare Oscar/Certification
311504Medicare PIN