Provider Demographics
NPI:1407275142
Name:SAMARITAN HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:SAMARITAN HEALTH SERVICES, INC.
Other - Org Name:SAMFIT-ALBANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:TRIEBES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:541-812-4102
Mailing Address - Street 1:380 HICKORY ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1726
Mailing Address - Country:US
Mailing Address - Phone:541-926-2264
Mailing Address - Fax:
Practice Address - Street 1:380 HICKORY ST NW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1726
Practice Address - Country:US
Practice Address - Phone:541-926-2264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service