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General NPI Number Information
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NPI Number | 1124230511
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Entity Type | Organization
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Legal Business Name | GOOD SAMARITAN THERAPIES INC
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Dates
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Enumeration Date | 05/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 106 ROSE ST
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City | JONESBORO
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State | AR
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Zip | 72401-5959
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Country | US
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Telephone | 870-268-8333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3744
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City | STATE UNIVERSITY
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State | AR
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Zip | 72467-3744
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Country | US
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Telephone | 870-268-8333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHERRI LOVELACE
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Credential | SLP
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Telephone | 870-931-5981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 5C607
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License Number State | AR
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