| Good Samaritan Family Practice 100 | |
|
406 N 1st St Ste D Vincennes IN 47591-1358 | |
| (812) 885-0524 | |
| (812) 885-0523 |
| Full Name | Good Samaritan Family Practice 100 |
|---|---|
| Speciality | Clinic/Center |
| Location | 406 N 1st St Ste D, Vincennes, Indiana |
| Authorized Official Name and Position | Robert Mclin (CEO) |
| Authorized Official Contact | 8128825220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Samaritan Family Practice 100 1160 E Saint Clair St Vincennes IN 47591-4853 Ph: (812) 885-3325 | Good Samaritan Family Practice 100 406 N 1st St Ste D Vincennes IN 47591-1358 Ph: (812) 885-0524 |
| NPI Number | 1760145973 |
|---|---|
| Provider Enumeration Date | 10/15/2021 |
| Last Update Date | 06/12/2023 |
| Medicare PECOS PAC ID | 9436061918 |
|---|---|
| Medicare Enrollment ID | O20230803001757 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760145973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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