Healthcare Provider Details

I. General information

NPI: 1427259498
Provider Name (Legal Business Name): SAMARITAN NORTH LINCOLN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3043 NE 28TH ST
LINCOLN CITY OR
97367-4518
US

IV. Provider business mailing address

3043 NE 28TH ST
LINCOLN CITY OR
97367-4518
US

V. Phone/Fax

Practice location:
  • Phone: 541-996-7231
  • Fax:
Mailing address:
  • Phone: 541-996-7375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRP-0000874-CS
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberIP-0000018
License Number StateOR

VIII. Authorized Official

Name: LESLIE J. OGDEN
Title or Position: CEO
Credential:
Phone: 541-996-7100