Provider Demographics
NPI:1154605632
Name:SAMARITAN HOSPITAL
Entity type:Organization
Organization Name:SAMARITAN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL VERIFICATION SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-270-3008
Mailing Address - Street 1:122 1ST ST
Mailing Address - Street 2:APT #3E
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-4430
Mailing Address - Country:US
Mailing Address - Phone:518-326-0095
Mailing Address - Fax:
Practice Address - Street 1:122 1ST ST
Practice Address - Street 2:3E
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-4430
Practice Address - Country:US
Practice Address - Phone:518-326-0095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP82121273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit