Provider Demographics
NPI:1336774751
Name:GOOD SAMARITAN HOSPITAL CORVALLIS
Entity type:Organization
Organization Name:GOOD SAMARITAN HOSPITAL CORVALLIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-768-5011
Mailing Address - Street 1:777 NW 9TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-6169
Mailing Address - Country:US
Mailing Address - Phone:541-768-6768
Mailing Address - Fax:541-768-9771
Practice Address - Street 1:3509 NW SAMARITAN DR STE 110
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3893
Practice Address - Country:US
Practice Address - Phone:541-768-4830
Practice Address - Fax:541-768-6190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOOD SAMARITAN HOSPITAL CORVALLIS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital