Healthcare Provider Details

I. General information

NPI: 1801428099
Provider Name (Legal Business Name): SAMARITAN REGIONAL HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2020
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 ASHLAND RD STE 173
MANSFIELD OH
44905-2156
US

IV. Provider business mailing address

PO BOX 772930
DETROIT MI
48277-2930
US

V. Phone/Fax

Practice location:
  • Phone: 456-345-3010
  • Fax: 567-345-3011
Mailing address:
  • Phone: 456-345-3010
  • Fax: 567-345-3011

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