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General NPI Number Information
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NPI Number | 1184622458
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Entity Type | Organization
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Legal Business Name | GOOD SAMARITAN HOSPITAL
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 520 S 7TH ST
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City | VINCENNES
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State | IN
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Zip | 47591-1038
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Country | US
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Telephone | 812-886-6800
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Fax | 812-886-6809
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Provider Business Mailing Address
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Address Line | 515 BAYOU ST
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City | VINCENNES
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State | IN
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Zip | 47591-1034
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Country | US
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Telephone | 812-886-6800
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Fax | 812-886-6809
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Authorized Official
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Title or Position | DIRECTOR FINANCIAL SERVICES
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Name | ANGELA BOTTOMS II
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Credential | C.P.A.
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Telephone | 812-885-2709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 05-005038-1
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 403-0
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 05-005038-1
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License Number State | IN
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