Provider Demographics
NPI:1811084965
Name:GOOD SAMARITAN HOME HEALTH CARE
Entity type:Organization
Organization Name:GOOD SAMARITAN HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILIP
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-416-7099
Mailing Address - Street 1:1718 CRESCENT OAK DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4543
Mailing Address - Country:US
Mailing Address - Phone:281-416-7099
Mailing Address - Fax:281-416-7099
Practice Address - Street 1:1718 CRESCENT OAK DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4543
Practice Address - Country:US
Practice Address - Phone:281-416-7099
Practice Address - Fax:281-416-7099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXNAMedicaid
TXNAMedicare ID - Type Unspecified