Provider Demographics
NPI:1932412269
Name:STEWARD GOOD SAMARITAN MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:STEWARD GOOD SAMARITAN MEDICAL CENTER, INC.
Other - Org Name:STEWARD HOME MEDICAL EQUIPMENT - GOOD SAMARITAN HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-789-2706
Mailing Address - Street 1:235 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1794
Mailing Address - Country:US
Mailing Address - Phone:508-427-2831
Mailing Address - Fax:617-562-7241
Practice Address - Street 1:907 SUMNER ST
Practice Address - Street 2:SUITE 205
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3374
Practice Address - Country:US
Practice Address - Phone:781-341-1918
Practice Address - Fax:866-740-7533
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEWARD HEALTH CARE SYSTEM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies