# GOOD SAMARITAN HOSPITAL CORVALLIS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Samaritan Specialty Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689343113
- **Authorized official:** LAURA ALFERD HENNUM (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (541) 768-5009

## Contact information

- **Practice address:** 3521 NW SAMARITAN DR STE 200, CORVALLIS, OR 97330-4744
- **Practice address phone:** (541) 768-5225
- **Practice address fax:** (541) 768-5224
- **Mailing address:** 2300 NW WALNUT BLVD LOWR LEVEL, CORVALLIS, OR 97330-3538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/08/2021
- **Last updated:** 10/29/2021