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Organization
THE GOOD SAMARITAN-A FAMILY HEALTH CARE FACILITY, INC
Active
Organization
THE GOOD SAMARITAN-A FAMILY HEALTH CARE FACILITY, INC
Active
Other names
Good Samaritan Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
FRED MCCLEAN (PRESIDENT)
(316) 688-5020
Entity
Organization
Contact information
Practice address
3701 E 13TH ST N, WICHITA, KS 67208-2080
(316) 688-5020
Mailing address
PO BOX 676, WICHITA, KS 67201-0676
(316) 685-3698
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016379
BCBS
KS
01
—
CS0608
RAILROAD MEDICARE
—
Enumeration date
05/17/2006
Last updated
08/22/2020
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