Basic Information
| Provider Information | |||||||||
| NPI: | 1265902084 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAMARITAN REGIONAL HEALTH SYSTEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 663 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448052616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192072502 | ||||||||
| FaxNumber: | 4192072394 | ||||||||
| Practice Location | |||||||||
| Address1: | 663 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448052616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192072502 | ||||||||
| FaxNumber: | 4192072394 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2018 | ||||||||
| LastUpdateDate: | 12/05/2018 | ||||||||
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| AuthorizedOfficialLastName: | VEHOVEC | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | RUSSELL | ||||||||
| AuthorizedOfficialTitleorPosition: | VP & CORPORATE CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 2167678729 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.