Provider Demographics
NPI:1942383781
Name:THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA
Entity Type:Organization
Organization Name:THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA
Other - Org Name:WELLSPAN GOOD SAMARITAN HOSPITAL INPATIENT MEDICAL REHAB UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-270-7503
Mailing Address - Street 1:785 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:30 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17046-5606
Practice Address - Country:US
Practice Address - Phone:717-270-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA072401273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007732780057Medicaid
PA000000056879OtherUNISON MEDPLUS
PA1018197OtherKEYSTONE MERCY
PA33781OtherHEALTH AMERICA
39T066OtherSTERLING OPTION 1
PA60685OtherAMERIHEALTH MERCY
PA7510OtherAETNA
PA39T066OtherCAPITAL BLUE CROSS
39T066OtherGEISINGER GOLD
PA1018197OtherGATEWAY HEALTH PLAN
PA1559OtherHIGHMARK FREEDOM BLUE
PA1559OtherHIGHMARK BLUE SHIELD
1018197OtherGATEWAY MEDICARE ASSURED
39T066OtherHUMANA GOLD
PA08274OtherHEALTH PARTNERS
PA1007732780037Medicaid
PA39T066OtherKEYSTONE HEALTH PLAN CENT
PA1007732780037Medicaid