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General NPI Number Information
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NPI Number | 1700876521
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Entity Type | Organization
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Legal Business Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 709 N LOWE ST
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City | HOBART
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State | OK
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Zip | 73651-1642
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Country | US
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Telephone | 580-726-3381
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Fax | 580-726-5043
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Provider Business Mailing Address
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Address Line | PO BOX 5038
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City | SIOUX FALLS
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State | SD
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Zip | 57117-5038
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Country | US
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Telephone | 605-362-3100
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Fax | 605-362-3265
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Authorized Official
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Title or Position | CFO
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Name | MS. RAYE NAE NYLANDER
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Credential |
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Telephone | 605-362-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | OK
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