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General NPI Number Information
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NPI Number | 1629254008
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Entity Type | Organization
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Legal Business Name | THE GOOD SAMARITAN HEALTH CENTER, INC.
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Dates
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Enumeration Date | 01/15/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1015 DONALD LEE HOLLOWELL PKWY NW
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City | ATLANTA
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State | GA
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Zip | 30318-6653
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Country | US
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Telephone | 404-523-6571
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Fax | 404-523-6574
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Provider Business Mailing Address
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Address Line | 1015 DONALD LEE HOLLOWELL PKWY NW
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City | ATLANTA
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State | GA
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Zip | 30318-6653
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Country | US
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Telephone | 404-523-6571
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Fax | 404-523-6574
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Authorized Official
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Title or Position | CEO/FOUNDER/PRESIDENT
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Name | DR. WILLIAM CHESTER WARREN IV
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Credential | M.D.
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Telephone | 404-523-6571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | GA
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