GOOD SAMARITAN HEALTH & WELLNESS CENTER NPI 1407174675

NPI Information

NPI: 1407174675
Provider Name: GOOD SAMARITAN HEALTH & WELLNESS CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 11D0996850

Address:
175 SAMARITAN DR
JASPER, GA
ZIP 30143
Phone: (706) 253-4673
Get Directions

GOOD SAMARITAN HEALTH & WELLNESS CENTER is a federally qualified health center (fqhc) clinic center in Jasper, GA. GOOD SAMARITAN HEALTH & WELLNESS CENTER NPI is 1407174675. The provider is registered as an organization entity type.

The provider's business location address is:

175 SAMARITAN DR
JASPER, GA
ZIP 30143-964
Phone: (706) 253-4673
Fax: (706) 253-4675

The provider's authorized official is Tammi W Sorrells .
The authorized official title is Ceo and has the following contact phone number (770) 815-0986.

The CLIA number assigned to this NPI record is 11D0996850 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/12/2010 and was last updated on 10/19/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »