Healthcare Provider Details

I. General information

NPI: 1265902084
Provider Name (Legal Business Name): SAMARITAN REGIONAL HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

663 E MAIN ST
ASHLAND OH
44805-2616
US

IV. Provider business mailing address

PO BOX 772930
DETROIT MI
48277-2930
US

V. Phone/Fax

Practice location:
  • Phone: 419-207-2502
  • Fax: 419-207-2394
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE GALLUCCI
Title or Position: VP CHIEF ACCOUNTING OFFICER
Credential:
Phone: 440-382-7894