Provider Demographics
NPI:1710211842
Name:GOOD SAMARITAN INC
Entity Type:Organization
Organization Name:GOOD SAMARITAN INC
Other - Org Name:GOOD SAMARITAN EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MBAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-887-7105
Mailing Address - Street 1:PO BOX 735
Mailing Address - Street 2:
Mailing Address - City:ALIEF
Mailing Address - State:TX
Mailing Address - Zip Code:77411-0735
Mailing Address - Country:US
Mailing Address - Phone:832-887-7105
Mailing Address - Fax:281-776-0630
Practice Address - Street 1:7000 COOK RD APT 301
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2259
Practice Address - Country:US
Practice Address - Phone:832-887-7105
Practice Address - Fax:281-776-0630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN