Healthcare Provider Details
I. General information
NPI: 1184614547
Provider Name (Legal Business Name): THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/26/2005
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1322 U ST
AUBURN NE
68305-3215
US
IV. Provider business mailing address
PO BOX 5038
SIOUX FALLS SD
57117-5038
US
V. Phone/Fax
- Phone: 402-274-4954
- Fax: 402-274-4424
- Phone: 605-328-6585
- Fax: 605-312-9802
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BN1400X |
| Taxonomy | Nursing Facility Supplies (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOEL
FLUIT
Title or Position: CFO
Credential:
Phone: 605-328-6585