Provider Demographics
NPI:1134423288
Name:SAMARITAN NORTH LINCOLN DIALYSIS
Entity type:Organization
Organization Name:SAMARITAN NORTH LINCOLN DIALYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:541-996-6441
Mailing Address - Street 1:2817 NE WEST DEVILS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-5128
Mailing Address - Country:US
Mailing Address - Phone:541-994-3661
Mailing Address - Fax:541-996-7386
Practice Address - Street 1:2817 NE WEST DEVILS LAKE RD
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-5128
Practice Address - Country:US
Practice Address - Phone:541-994-3661
Practice Address - Fax:541-996-7386
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAMARITAN NORTH LINCOLN HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment