Provider Demographics
NPI:1558025676
Name:THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA
Entity Type:Organization
Organization Name:THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA
Other - Org Name:WELLSPAN GOOD SAMARITAN HOSPITAL NON-PATIENT LAB
Other - Org Type:Other Name
Authorized Official - Title/Position:SR VP & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-270-7503
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:
Practice Address - Street 1:252 S 4TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-6111
Practice Address - Country:US
Practice Address - Phone:717-270-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory