Provider Demographics
NPI:1508835828
Name:THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO
Entity Type:Organization
Organization Name:THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-5126
Mailing Address - Street 1:619 OAK ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1613
Mailing Address - Country:US
Mailing Address - Phone:513-569-6302
Mailing Address - Fax:513-569-6513
Practice Address - Street 1:375 DIXMYTH AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220
Practice Address - Country:US
Practice Address - Phone:513-569-6302
Practice Address - Fax:513-569-6513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000002831OtherANTHEM
OH90443OtherAMERIGROUP
IN100275850AMedicaid
OH3293485Medicaid
OH5020027OtherUNITED HEALTH CARE
OH6460320OtherAETNA
KY0154043Medicaid
OH=========001OtherCARE SOURCE
OH3293485Medicaid