Provider Demographics
NPI:1477166064
Name:THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO
Entity Type:Organization
Organization Name:THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO
Other - Org Name:GOOD SAMARITAN ENDOSCOPY CENTER NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:CROFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-6577
Mailing Address - Street 1:4685 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3397
Mailing Address - Country:US
Mailing Address - Phone:513-853-4684
Mailing Address - Fax:513-852-8525
Practice Address - Street 1:10600 MONTGOMERY RD STE 101
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4464
Practice Address - Country:US
Practice Address - Phone:513-794-5680
Practice Address - Fax:513-791-6013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital