Provider Demographics
NPI:1568749141
Name:SAMARITIAN CARE, LLC
Entity Type:Organization
Organization Name:SAMARITIAN CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:K
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-300-6786
Mailing Address - Street 1:PO BOX 16183
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30919-2183
Mailing Address - Country:US
Mailing Address - Phone:706-364-5158
Mailing Address - Fax:706-364-5193
Practice Address - Street 1:1227 AUGUSTA WEST PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6670
Practice Address - Country:US
Practice Address - Phone:706-364-5158
Practice Address - Fax:706-364-5193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALCB20100001349251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management