Provider Demographics
NPI:1528311529
Name:GOOD SAMARITAN PHARMACY & HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:GOOD SAMARITAN PHARMACY & HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TROMP
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:941-445-5687
Mailing Address - Street 1:2502 TAMIAMI TRL N
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-3476
Mailing Address - Country:US
Mailing Address - Phone:941-445-5687
Mailing Address - Fax:
Practice Address - Street 1:225 TAMIAMI TRL S
Practice Address - Street 2:
Practice Address - City:NOKOMIS
Practice Address - State:FL
Practice Address - Zip Code:34275-3148
Practice Address - Country:US
Practice Address - Phone:941-445-5687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 23191251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable