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General NPI Number Information
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NPI Number | 1013127364
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Entity Type | Organization
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Legal Business Name | GOOD SAMARITAN CLINIC
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 305 W UNION ST
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City | MORGANTON
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State | NC
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Zip | 28655-3782
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Country | US
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Telephone | 828-439-9945
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Fax | 828-439-9917
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Provider Business Mailing Address
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Address Line | 305 W UNION ST
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City | MORGANTON
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State | NC
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Zip | 28655-3782
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Country | US
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Telephone | 828-439-9945
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Fax | 828-439-9917
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WILLIAM JOHANSON
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Credential | M.D.
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Telephone | 828-439-9616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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