Organization
SAMARITAN FAMILY CARE, INC
Active
Other names
Gem City Surgical Breast Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH PRUNIER (PRESIDENT/CEO)
(937) 499-8204
Entity
Organization
Contact information
Practice address
9000 N MAIN ST, DAYTON, OH 45415-1180
(937) 832-9310
(937) 832-8616
Mailing address
9000 N MAIN ST, DAYTON, OH 45415-1180
(937) 832-9310
(937) 832-8616
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0081226
—
OH
Enumeration date
02/08/2013
Last updated
11/08/2013
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