Provider Demographics
NPI:1245209576
Name:THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO
Entity Type:Organization
Organization Name:THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, PATIENTACCOUNTS
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:AYLWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-6302
Mailing Address - Street 1:619 OAK ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1613
Mailing Address - Country:US
Mailing Address - Phone:516-569-6302
Mailing Address - Fax:513-569-6513
Practice Address - Street 1:375 DIXMYTH AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2475
Practice Address - Country:US
Practice Address - Phone:513-569-6302
Practice Address - Fax:513-569-6513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3293485Medicaid
KY01540434Medicaid
OH6460320OtherUNITED HEALTH CARE
OH6460320OtherAETNA
OH90443OtherAMEIGROUP
OH000000002831OtherANTHEM
OH6460320OtherUNITED HEALTH CARE
OH36S134Medicare ID - Type UnspecifiedPSYCHIATRY