Provider Demographics
NPI:1336574912
Name:SAMARITAN PACIFIC HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:SAMARITAN PACIFIC HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-574-1814
Mailing Address - Street 1:775 SW 9TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-4850
Mailing Address - Country:US
Mailing Address - Phone:541-265-2007
Mailing Address - Fax:541-265-3533
Practice Address - Street 1:775 SW 9TH ST STE B
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-4850
Practice Address - Country:US
Practice Address - Phone:541-265-2007
Practice Address - Fax:541-265-3533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty