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Organization
THE GOOD SAMARITAN HOSPITAL
Active
Organization
THE GOOD SAMARITAN HOSPITAL
Active
Parent organization
THE GOOD SAMARITAN HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE GOOD SAMARITAN HOSPITAL
Authorized official
ROBERT J RICHARDS (VP FINANCE & CFO)
(717) 270-7806
Entity
Organization
Contact information
Practice address
FOURTH AND WALNUT STREETS, LEBANON, PA 17042
(717) 274-7580
(717) 228-0249
Mailing address
PO BOX 1281, LEBANON, PA 17042-1281
(717) 274-7580
(717) 228-0249
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
072401
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005267
RAILROAD MEDICARE
—
01
—
1017455
GATEWAY MEDICARE ASSURED
PA
01
—
116415000
FEDERAL WORK COMP
PA
01
—
1373454
HIGHMARK BLUE SHIELD
PA
01
—
1373454
HIGHMARK FREEDOM BLUE
—
01
—
145461
BS 65(MEDIGAP CROSS OVER)
PA
Enumeration date
11/03/2006
Last updated
11/13/2007
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