Organization
GOOD SAMARITAN HOSPITAL
Active
Parent organization
MEDICAL HOME
Other names
Medical Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL HOME
Authorized official
ROBERT D MCLIN (CEO)
(812) 885-3333
Entity
Organization
Contact information
Practice address
429 S 6TH ST, VINCENNES, IN 47591-1022
(812) 885-3703
(812) 885-3707
Mailing address
520 S 7TH ST, VINCENNES, IN 47591-1038
(812) 882-5220
(812) 885-3737
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270150
—
IN
Enumeration date
06/21/2013
Last updated
11/12/2015
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