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NPI Code Detail

MEDICARE: GOOD SAMARITAN HOSPITAL

MEDICARE: GOOD SAMARITAN HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker05-005038-1IN
22084P0800XPsychiatry Physician403-0IN
3273R00000XPsychiatric Hospital Unit05-005038-1IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1301936OTHERINVALUE OPTIONS FACILITY
2000000574014OTHERINANTHEM PIN FOR THIS LOCATION
3039738000OTHERINMAGELLAN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184622458
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOOD SAMARITAN HOSPITAL
Provider Business Mailing Address
First Line : 515 BAYOU ST
Second Line :
City : VINCENNES
State : IN
Zip : 47591-1034
Country : US
Telephone Number : 812-886-6800
Fax Number : 812-886-6809
Provider Business Practice Location Address
First Line : 520 S 7TH ST
Second Line :
City : VINCENNES
State : IN
Zip : 47591-1038
Country : US
Telephone Number : 812-886-6800
Fax Number : 812-886-6809
Authorized Official
Title or Position : DIRECTOR FINANCIAL SERVICES
Name : ANGELA BOTTOMS II
Credential : C.P.A.
Telephone Number : 812-885-2709
Provider Enumeration Date : 07/12/2005
Last Update Date : 02/24/2011

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1891793634 — PHILIP V BACIDORE DO
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1114927456 — DR. MICHAEL DULIN MD
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Directions to “GOOD SAMARITAN HOSPITAL ” Practice Location

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