Provider Demographics
NPI:1487675559
Name:GOOD SAMARITAN REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:GOOD SAMARITAN REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OUT-PATIENT SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-621-4944
Mailing Address - Street 1:10 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:FRACKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17931-2418
Mailing Address - Country:US
Mailing Address - Phone:570-874-4289
Mailing Address - Fax:570-874-1228
Practice Address - Street 1:10 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:FRACKVILLE
Practice Address - State:PA
Practice Address - Zip Code:17931-2418
Practice Address - Country:US
Practice Address - Phone:570-874-4289
Practice Address - Fax:570-874-1228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUPOO5273B261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center