MEDICARE: SAMARITAN PACIFIC HEALTH SERVICES, 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
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1568543692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMARITAN PACIFIC HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	199 W HIGHWAY 20
Second Line	:
City	:	TOLEDO
State	:	OR
Zip	:	97391-1242
Country	:	US
Telephone Number	:	541-574-2730
Fax Number	:	541-336-7614

Provider Business Practice Location Address
First Line	:	199 WEST HIGHWAY 20
Second Line	:
City	:	TOLEDO
State	:	OR
Zip	:	97391
Country	:	US
Telephone Number	:	541-574-2730
Fax Number	:	541-336-7614

Authorized Official
Title or Position	:	CEO
Name	:	LESLEY OGDEN
Credential	:	MD
Telephone Number	:	541-574-1814

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	11/03/2025

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