Provider Demographics
NPI:1922247675
Name:CARITAS GOOD SAMARITAN MEDICAL CENTER
Entity Type:Organization
Organization Name:CARITAS GOOD SAMARITAN MEDICAL CENTER
Other - Org Name:CARITAS NORCAP LODGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE CONTACT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-427-2217
Mailing Address - Street 1:71 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2533
Mailing Address - Country:US
Mailing Address - Phone:508-543-1873
Mailing Address - Fax:508-698-1142
Practice Address - Street 1:235 N PEARL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1794
Practice Address - Country:US
Practice Address - Phone:508-427-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARITAS GOOD SAMARITAN MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARNP125199282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP0835Medicare PIN