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NPI Code Detail

MEDICARE: GOOD SAMARITAN HEALTH & WELLNESS CENTER INC.

MEDICARE: GOOD SAMARITAN HEALTH & WELLNESS CENTER INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center
2261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1407174675
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOOD SAMARITAN HEALTH & WELLNESS CENTER INC.
Provider Business Mailing Address
First Line : 175 SAMARITAN DR
Second Line :
City : JASPER
State : GA
Zip : 30143-1964
Country : US
Telephone Number : 706-253-4633
Fax Number : 706-253-4631
Provider Business Practice Location Address
First Line : 175 SAMARITAN DR
Second Line :
City : JASPER
State : GA
Zip : 30143-1964
Country : US
Telephone Number : 706-253-4673
Fax Number : 706-253-4675
Authorized Official
Title or Position : CEO
Name : TAMMI W SORRELLS
Credential :
Telephone Number : 770-815-0986
Provider Enumeration Date : 05/12/2010
Last Update Date : 12/04/2025

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Directions to “GOOD SAMARITAN HEALTH & WELLNESS CENTER INC. ” Practice Location

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