Provider Demographics
NPI:1710102611
Name:GOOD SAMARITAN MEDICAL SUPPLY
Entity Type:Organization
Organization Name:GOOD SAMARITAN MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-693-5758
Mailing Address - Street 1:10267 MOROCCO RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-7429
Mailing Address - Country:US
Mailing Address - Phone:832-693-5758
Mailing Address - Fax:713-794-5274
Practice Address - Street 1:10267 MOROCCO RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-7429
Practice Address - Country:US
Practice Address - Phone:832-693-5758
Practice Address - Fax:713-794-5274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)