MEDICARE: THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA

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
1	207P00000X	Emergency Medicine Physician
2	207ZC0006X	Clinical Pathology Physician
3	261QA1903X	Ambulatory Surgical Clinic/Center
4	261QR0200X	Radiology Clinic/Center
5	261QX0203X	Radiation Oncology Clinic/Center
6	282N00000X	General Acute Care Hospital	072401	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407928500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:	717-851-6969

Provider Business Practice Location Address
First Line	:	252 S 4TH ST
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-6123
Country	:	US
Telephone Number	:	717-270-7500
Fax Number	:

Authorized Official
Title or Position	:	VP & PRESIDENT
Name	:	TINA CITRO
Credential	:
Telephone Number	:	717-738-6407

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	04/30/2025

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Directions to “THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA ” Practice Location

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