Provider Demographics
NPI:1861503252
Name:SAMARITAN HEALTHCARE, INC
Entity Type:Organization
Organization Name:SAMARITAN HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCCURDY
Authorized Official - Suffix:
Authorized Official - Credentials:RN,
Authorized Official - Phone:704-878-0522
Mailing Address - Street 1:1433 DAVIE AVE
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-3515
Mailing Address - Country:US
Mailing Address - Phone:704-878-0522
Mailing Address - Fax:704-878-0560
Practice Address - Street 1:1433 DAVIE AVE
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-3515
Practice Address - Country:US
Practice Address - Phone:704-878-0522
Practice Address - Fax:704-878-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2806251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408138Medicaid
NC6800470Medicaid
NC6601167Medicaid