Provider Demographics
NPI:1932598018
Name:GOOD SAMARITAN HOSPITAL PHYSICIAN SERVICES, INC
Entity Type:Organization
Organization Name:GOOD SAMARITAN HOSPITAL PHYSICIAN SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-885-3333
Mailing Address - Street 1:2005 STATE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-8558
Mailing Address - Country:US
Mailing Address - Phone:812-254-4650
Mailing Address - Fax:812-254-4081
Practice Address - Street 1:2005 STATE ST
Practice Address - Street 2:SUITE A
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-8558
Practice Address - Country:US
Practice Address - Phone:812-254-4650
Practice Address - Fax:812-254-4081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health