Healthcare Provider Details

I. General information

NPI: 1205902343
Provider Name (Legal Business Name): THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 SOUTH 4TH STREET
LEBANON PA
17042-6123
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-270-7500
  • Fax:
Mailing address:
  • Phone: 717-851-1405
  • Fax: 717-851-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number072401
License Number StatePA

VIII. Authorized Official

Name: TINA CITRO
Title or Position: VP & PRESIDENT
Credential:
Phone: 717-738-6407