Hines Good Samaritan Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL034077 Issued in NC

Legal business name

HINES GOOD SAMARITAN HOME

Practice address

2317 Elbon Dr
Winston Salem, NC 27105-5649

Phone

(336) 722-7818

NPI assigned

Apr 28, 2008

Last updated

May 5, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Margaretta Hines Moore

Title

Administrator

Phone

(336) 727-1308

Specialties & licenses 1

Addresses

Tax ID family

Hines Good Samaritan Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hines Good Samaritan Home

  • Adult Companion
  • Winston Salem, NC
  • NPI 1740545284
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1912172198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 MANCHESTER ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271055536",
            "telephone_number": "336-727-1308",
            "fax_number": "336-723-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 ELBON DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271055649",
            "telephone_number": "336-722-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HINES GOOD SAMARITAN HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARGARETTA",
        "authorized_official_middle_name": "HINES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-727-1308",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL034077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Grace Himes
• Jessica Lynn Hinaman Destefano
• Molly Hinely, PHARMD, CPP
• Hines Family Services Inc
• Hines Good Samaritan Home
• Anne Creech Hines, M.D.
• Bethany Rose Pavlinchak Hines, MD
• Courtney Tysinger Hines, PHARMD
• Daisy Marie Hines, LCMHCA
• Janice Nelina Hines, MSW

• Adult Care Home Facility in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.