Provider Demographics
NPI:1770232399
Name:HAMBLEN, SAMANTHA RUTH
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:RUTH
Last Name:HAMBLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8517 VINEYARD AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-6620
Mailing Address - Country:US
Mailing Address - Phone:216-450-8985
Mailing Address - Fax:
Practice Address - Street 1:3726 W 42ND ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-2472
Practice Address - Country:US
Practice Address - Phone:216-310-8142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health