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
2085R0204X
Vascular & Interventional Radiology Physician
Primary
072401
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1365655
HIGHMARK BLUE SHIELD
PA
01
—
1365655
HIGHMARK FREEDOM BLUE
—
01
—
1521465
GATEWAY MEDICARE ASSURED
PA
01
—
521957
BS 65(MEDIGAP CROSS OVER)
PA
01
—
521957
GEISINGER GOLD
—
Enumeration date
11/01/2006
Last updated
11/13/2007
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