Provider Demographics
NPI:1245599224
Name:SAMARITAN NORTH LINCOLN HOSPITAL
Entity Type:Organization
Organization Name:SAMARITAN NORTH LINCOLN HOSPITAL
Other - Org Name:SAMARITAN KIDNEY SPECIALISTS - LINCOLN CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:OGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-996-7100
Mailing Address - Street 1:3100 NE 28TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-4524
Mailing Address - Country:US
Mailing Address - Phone:541-768-6930
Mailing Address - Fax:
Practice Address - Street 1:3100 NE 28TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367
Practice Address - Country:US
Practice Address - Phone:541-768-6930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-10
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500652915Medicaid
OR500652915Medicaid