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NPI Code Detail

MEDICARE: GOOD SAMARITAN FAMILY HEALTH CENTER, INC

MEDICARE: GOOD SAMARITAN FAMILY HEALTH CENTER, INC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1831808971
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOOD SAMARITAN FAMILY HEALTH CENTER, INC
Provider Business Mailing Address
First Line : PO BOX 556
Second Line :
City : VINCENNES
State : IN
Zip : 47591-0556
Country : US
Telephone Number : 812-494-9501
Fax Number : 812-494-9502
Provider Business Practice Location Address
First Line : 300 N 1ST ST
Second Line :
City : VINCENNES
State : IN
Zip : 47591-1252
Country : US
Telephone Number : 812-885-2718
Fax Number : 812-885-2727
Authorized Official
Title or Position : CEO
Name : JENNIFER EMMONS
Credential :
Telephone Number : 812-494-7800
Provider Enumeration Date : 11/17/2022
Last Update Date : 03/25/2024

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