Provider Demographics
NPI:1851941876
Name:GOOD SAMARITAN MED SUPPLY INC
Entity Type:Organization
Organization Name:GOOD SAMARITAN MED SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:JOANNE
Authorized Official - Last Name:TORREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-783-1700
Mailing Address - Street 1:37555 SYCAMORE ST STE 7
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-3939
Mailing Address - Country:US
Mailing Address - Phone:510-742-2472
Mailing Address - Fax:510-742-2462
Practice Address - Street 1:37555 SYCAMORE ST STE 7
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-3939
Practice Address - Country:US
Practice Address - Phone:510-742-2472
Practice Address - Fax:510-742-2462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies