Good Samaritan Health Center Of Cobb

LBN: Good Samaritan Health Center Of Cobb
Good Samaritan Health Center Of Cobb is an health care organization with primary practice located at 1605 Roberta Dr Sw , Marietta GA 30008-3855. The organization recently has 2 registered licenses in different health care specialties including Agencies / Voluntary or Charitable, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Good Samaritan Health Center Of Cobb can be contacted via phone (404) 937-3850, or through Mathisen, Rory via phone (251) 751-2021.

Contact Information

Primary practice address
1605 Roberta Dr Sw Marietta GA 30008-3855
Fax: (770) 419-3121
Website:
Authorized official contact:
Name: Mathisen, Rory MPH

Health care specialties

SpecialtyCodeLicense #State
Agencies / Voluntary or Charitable 251V00000X 054389 Georgia
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X Georgia

Profile Details

NPI number 1881923126
LBN Legal business name Good Samaritan Health Center Of Cobb
DBA Doing business as
Authorized official Mathisen, Rory MPH
Entity Organization
Organization subpart 1 No
Enumeration date Dec 16th, 2009
Last updated Sep 23rd, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881923126 NPPES
Other 202G703251 MEDICARE PART B
MEDICAID 01000654 MEDICARE PART B
Other 08BBRXN MEDICARE PART B
MEDICAID 003151808A MEDICARE PART B
Other 111043 MEDICARE PART B

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