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GOOD SAMARITAN HOSPITAL CORVALLIS NPI 1235409236


NPI Information

NPI: 1235409236
Provider Name: GOOD SAMARITAN HOSPITAL CORVALLIS

Doing Business As: SAMARITAN UROLOGY

Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 38D2003753

Address:
990 NW CIRCLE BLVD SUITE 102
CORVALLIS, OR
ZIP 97330
Phone: (541) 768-5486
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GOOD SAMARITAN HOSPITAL CORVALLIS is an urology in Corvallis, OR. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. GOOD SAMARITAN HOSPITAL CORVALLIS NPI is 1235409236. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Samaritan Urology.

The provider's business location address is:

990 NW CIRCLE BLVD SUITE 102
CORVALLIS, OR
ZIP 97330-967
Phone: (541) 768-5486
Fax: (541) 768-5484

The provider's authorized official is Becky Pape .
The authorized official title is Coo and has the following contact phone number (541) 768-5009.

The CLIA number assigned to this NPI record is 38D2003753 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/6/2012 and was last updated on 3/16/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrologyNo
2208800000XUrology14-1074-1OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1500651453MEDICAIDOREGON

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: 4/28/2024

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