Good Samaritan Plaza Pharmacy

LBN: Good Samaritan Regional Health Center
Good Samaritan Plaza Pharmacy is an health care organization with primary practice located at 2 Good Samaritan Way Suite 120, Mount Vernon IL 62864-2475. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Good Samaritan Regional Health Center can be contacted via phone (618) 899-4999, or through Ellis, Michell R. via phone (618) 899-4999.

Contact Information

Primary practice address
2 Good Samaritan Way Suite 120 Mount Vernon IL 62864-2475
Phone: (618) 899-4999
Fax: (618) 899-4799
Website:
Map and Directions
Authorized official contact:
Name: Ellis, Michell R.
Phone: (618) 899-4999

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 054.018065 Illinois

Profile Details

NPI number 1316282163
LBN Legal business name Good Samaritan Regional Health Center
DBA Doing business as Good Samaritan Plaza Pharmacy
Authorized official Ellis, Michell R.
Entity Organization
Organization subpart 1 No
Enumeration date Dec 5th, 2012
Last updated Feb 28th, 2013 - about 11 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 1316282163 NPPES
Other 1487556 NCPDP PROVIDER IDENTIFICATION NUMBER

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