Healthcare Provider Details

I. General information

NPI: 1598936452
Provider Name (Legal Business Name): SAMARITAN FAMILY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 UNION ROAD
ENGLEWOOD OH
45322
US

IV. Provider business mailing address

885 UNION ROAD
ENGLEWOOD OH
45322
US

V. Phone/Fax

Practice location:
  • Phone: 937-836-3427
  • Fax: 937-836-3808
Mailing address:
  • Phone: 937-836-3427
  • Fax: 937-836-3808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: KENNETH PRUNIER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 937-208-8213