Provider Demographics
NPI:1255489670
Name:SAMARITAN NORTH LINCOLN HOSPITAL
Entity Type:Organization
Organization Name:SAMARITAN NORTH LINCOLN HOSPITAL
Other - Org Name:SAMARITAN NORTH LINCOLN HOSPICE
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 1:3011 NE 28TH STREET
Mailing Address - Street 2:
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-4524
Mailing Address - Country:US
Mailing Address - Phone:541-996-7328
Mailing Address - Fax:541-996-7397
Practice Address - Street 1:3011 NE 28TH STREET
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-4524
Practice Address - Country:US
Practice Address - Phone:541-996-7328
Practice Address - Fax:541-996-7397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16-1049315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR131958Medicaid
OR381540Medicare Oscar/Certification