Provider Demographics
NPI:1164757803
Name:GOOD SAMARITAN HOSPITAL
Entity Type:Organization
Organization Name:GOOD SAMARITAN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVANCED NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROCKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:513-862-3560
Mailing Address - Street 1:235 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-2609
Mailing Address - Country:US
Mailing Address - Phone:513-761-7316
Mailing Address - Fax:
Practice Address - Street 1:235 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-2609
Practice Address - Country:US
Practice Address - Phone:513-761-7316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRX.04696282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access