1427259498 NPI number — SAMARITAN NORTH LINCOLN HOSPITAL

Table of content: (NPI 1427259498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427259498 NPI number — SAMARITAN NORTH LINCOLN HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAMARITAN NORTH LINCOLN HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SAMARITAN NORTH LINCOLN PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427259498
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3043 NE 28TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINCOLN CITY
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97367-4518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-996-7375
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3043 NE 28TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLN CITY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97367-4518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-996-7231
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
OGDEN
Authorized Official First Name:
LESLIE
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
541-996-7100

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  RP-0000874-CS , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336I0012X , with the licence number: IP-0000018 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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