Provider Demographics
NPI:1942698154
Name:SAMARITAN NORTH LINCOLN HOSPITAL
Entity Type:Organization
Organization Name:SAMARITAN NORTH LINCOLN HOSPITAL
Other - Org Name:SAMARITAN OCCUPATIONAL MEDICINE-LINCOLN CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:OGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-996-7100
Mailing Address - Street 1:2930 NE WEST DEVILS LAKE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-5195
Mailing Address - Country:US
Mailing Address - Phone:541-557-6427
Mailing Address - Fax:
Practice Address - Street 1:2930 NE WEST DEVILS LAKE RD STE 3
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-5195
Practice Address - Country:US
Practice Address - Phone:541-557-6427
Practice Address - Fax:541-812-2071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500748439Medicaid