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NPI Code Detail

MEDICARE: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

MEDICARE: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BN1400XNursing Facility Supplies (DME)
2332BP3500XParenteral & Enteral Nutrition Supplies (DME)
3314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100687OTHERNEBLUE CROSS BLUE SHIELD
2F248043OTHERNEMIDLANDS CHOICE

General Provider Information

NPI Number : 1184614547
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Provider Business Mailing Address
First Line : PO BOX 5038
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5038
Country : US
Telephone Number : 605-362-3100
Fax Number : 605-362-3265
Provider Business Practice Location Address
First Line : 1322 U ST
Second Line :
City : AUBURN
State : NE
Zip : 68305-3215
Country : US
Telephone Number : 402-274-4954
Fax Number : 402-274-4424
Authorized Official
Title or Position : CFO
Name : MS. RAYE NAE NYLANDER
Credential :
Telephone Number : 605-362-3100
Provider Enumeration Date : 10/26/2005
Last Update Date : 11/28/2021

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Directions to “THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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