Wellspan Family Medicine - North Fourth Street
LBN: Good Samaritan Physician Services
Wellspan Family Medicine - North Fourth Street is an health care organization with primary practice located at 30 N 4Th St 2Nd Floor, Lebanon PA 17046-5606. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Good Samaritan Physician Services can be contacted via phone (717) 274-0474, or through Boger, Jody M via phone (717) 270-7780.
Contact Information
Primary practice address
30 N 4Th St 2Nd Floor
Lebanon PA 17046-5606
Phone: (717) 274-0474
Fax: (717) 274-0673
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X |
Profile Details
| NPI number | 1316076961 |
|---|---|
| LBN Legal business name | Good Samaritan Physician Services |
| DBA Doing business as | Wellspan Family Medicine - North Fourth Street |
| Authorized official | Boger, Jody M |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 2nd, 2007 |
| Last updated | Oct 4th, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316076961 | NPPES |
| Pennsylvania | MEDICAID | 001864024 |
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