Healthcare Provider Details

I. General information

NPI: 1528979655
Provider Name (Legal Business Name): THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4623 WESLEY AVE STE N
CINCINNATI OH
45212-2272
US

IV. Provider business mailing address

625 EDEN PARK DR
CINCINNATI OH
45202-6005
US

V. Phone/Fax

Practice location:
  • Phone: 513-569-6071
  • Fax: 513-569-6234
Mailing address:
  • Phone: 513-569-6577
  • Fax: 513-569-6489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL W CROFTON
Title or Position: VICE PRESIDENT FINANCE
Credential:
Phone: 513-569-6577