| Good Samaritan Physician Services | |
|
30 N 4th St 2nd Floor Lebanon PA 17046-5606 | |
| (717) 274-0474 | |
| (717) 274-0673 |
| Full Name | Good Samaritan Physician Services |
|---|---|
| Speciality | Family Medicine |
| Location | 30 N 4th St, Lebanon, Pennsylvania |
| Authorized Official Name and Position | Jody M Boger (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7172707780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Samaritan Physician Services Po Box 300 Lebanon PA 17042-0300 Ph: (717) 270-7780 | Good Samaritan Physician Services 30 N 4th St 2nd Floor Lebanon PA 17046-5606 Ph: (717) 274-0474 |
| NPI Number | 1316076961 |
|---|---|
| Provider Enumeration Date | 03/02/2007 |
| Last Update Date | 10/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316076961 | NPI | - | NPPES |
| 001864024 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
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The Good Samaritan Hospital Of Lebanon, Pennsylvania Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 252 South 4th Street, Lebanon, PA 17042 Phone: 717-270-7500 | |
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