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General NPI Number Information
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NPI Number | 1689668063
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Entity Type | Organization
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Legal Business Name | SAMARITAN CARE CENTER INC
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 806 E WASHINGTON ST
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City | MEDINA
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State | OH
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Zip | 44256-2128
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Country | US
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Telephone | 330-725-4123
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Fax | 330-723-2412
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Provider Business Mailing Address
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Address Line | PO BOX 8309 1207 N HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43201-0309
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Country | US
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Telephone | 614-299-3100
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Fax | 614-299-3813
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT C BANASIK
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Credential | PHD
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Telephone | 614-299-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0434
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License Number State | OH
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