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NPI Code Detail

MEDICARE: SAMARITAN FAMILY CARE, INC.

MEDICARE: SAMARITAN FAMILY CARE, 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
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851344501
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAMARITAN FAMILY CARE, INC.
Provider Business Mailing Address
First Line : 950 SALEM ST
Second Line :
City : BROOKVILLE
State : OH
Zip : 45309-8227
Country : US
Telephone Number : 937-833-4581
Fax Number : 937-833-5359
Provider Business Practice Location Address
First Line : 950 SALEM ST
Second Line :
City : BROOKVILLE
State : OH
Zip : 45309-8227
Country : US
Telephone Number : 937-833-4581
Fax Number : 937-833-5359
Authorized Official
Title or Position : CEO/PRESIDENT
Name : KENNETH PRUNIER
Credential :
Telephone Number : 937-208-8213
Provider Enumeration Date : 05/17/2006
Last Update Date : 11/08/2013

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Directions to “SAMARITAN FAMILY CARE, INC. ” Practice Location

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