Healthcare Provider Details
I. General information
NPI: 1598234056
Provider Name (Legal Business Name): SAMARITAN HEALTH CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/14/2018
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
811 E KENT RD
GREENVILLE MI
48838-9791
US
IV. Provider business mailing address
3735 NORTON HILLS RD
NORTON SHORES MI
49441-4469
US
V. Phone/Fax
- Phone: 616-225-0202
- Fax: 616-225-0207
- Phone: 231-780-0484
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROSS
POPE
Title or Position: CEO
Credential:
Phone: 616-502-0238