The Good Samaritan Free Clinic, INC
Health Maintenance Organization in Fort Pierce, FL. Organization (NPI-2).
NPI number1760802458
StatusActive
Last updated in NPPESApr 21, 2014
Details
- NPI
- 1760802458
- Entity type
- Organization (NPI-2)
- Legal business name
- The Good Samaritan Free Clinic, INC
- Organization subpart
- No
- Enumeration date
- Apr 21, 2014
- Last updated
- Apr 21, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302R00000X | Health Maintenance Organization | RN9338409 | FL | Yes |
Practice location
2601 Virginia AveFort Pierce, FL 34981-5539
Phone 772-924-1137
Mailing address
Po Box 3035Fort Pierce, FL 34948-3035
Phone 772-924-1137
Authorized official
Eva Bryant
Executive Assistant
7728799383
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