Healthcare Provider Details

I. General information

NPI: 1336865252
Provider Name (Legal Business Name): SAMARITAN HEALTH CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 E KENT RD
GREENVILLE MI
48838-9791
US

IV. Provider business mailing address

811 E KENT RD
GREENVILLE MI
48838-9791
US

V. Phone/Fax

Practice location:
  • Phone: 616-225-0202
  • Fax: 616-225-0207
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROSS POPE
Title or Position: CEO
Credential:
Phone: 616-502-0238