Healthcare Provider Details
I. General information
NPI: 1942383781
Provider Name (Legal Business Name): THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 N 4TH ST
LEBANON PA
17046-5606
US
IV. Provider business mailing address
601 MEMORY LN
YORK PA
17402-2231
US
V. Phone/Fax
- Phone: 717-270-7500
- Fax:
- Phone: 717-851-1405
- Fax: 717-851-6969
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 273Y00000X |
| Taxonomy | Rehabilitation Hospital Unit |
| License Number | 072401 |
| License Number State | PA |
VIII. Authorized Official
Name:
TINA
CITRO
Title or Position: VP & PRESIDENT
Credential:
Phone: 717-738-6407