Provider Demographics
NPI:1811146681
Name:GOOD SAMARITAN HOSPITAL
Entity type:Organization
Organization Name:GOOD SAMARITAN HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-882-5220
Mailing Address - Street 1:1701 MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-5431
Mailing Address - Country:US
Mailing Address - Phone:812-985-0055
Mailing Address - Fax:812-985-0088
Practice Address - Street 1:1701 MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-5431
Practice Address - Country:US
Practice Address - Phone:812-985-0055
Practice Address - Fax:812-985-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN160109302314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201274710Medicaid
IN201274710Medicaid