| Samaritan Homeless Clinic | |
|
921 S. Edwin C. Moses Blvd. Dayton OH 45417-3464 | |
| (937) 461-1376 | |
| (937) 499-7813 |
| Full Name | Samaritan Homeless Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 921 S. Edwin C. Moses Blvd., Dayton, Ohio |
| Authorized Official Name and Position | Timothy D. Snider (CFO) |
| Authorized Official Contact | 9372782254 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Samaritan Homeless Clinic 921 S. Edwin C. Moses Blvd. Dayton OH 45417-3464 Ph: (937) 461-1376 | Samaritan Homeless Clinic 921 S. Edwin C. Moses Blvd. Dayton OH 45417-3464 Ph: (937) 461-1376 |
| NPI Number | 1730387333 |
|---|---|
| Provider Enumeration Date | 07/05/2007 |
| Last Update Date | 12/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730387333 | NPI | - | NPPES |
| 2390470 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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