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General NPI Number Information
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NPI Number | 1851344501
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Entity Type | Organization
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Legal Business Name | SAMARITAN FAMILY CARE, INC.
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 950 SALEM ST
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City | BROOKVILLE
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State | OH
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Zip | 45309-8227
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Country | US
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Telephone | 937-833-4581
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Fax | 937-833-5359
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Provider Business Mailing Address
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Address Line | 950 SALEM ST
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City | BROOKVILLE
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State | OH
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Zip | 45309-8227
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Country | US
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Telephone | 937-833-4581
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Fax | 937-833-5359
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | KENNETH PRUNIER
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Credential |
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Telephone | 937-208-8213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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