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General NPI Number Information
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NPI Number | 1891786174
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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 | 11/04/2005
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2500 HINKLE DR
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City | DENTON
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State | TX
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Zip | 76201-0739
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Country | US
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Telephone | 940-383-2651
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Fax | 940-382-9306
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Provider Business Mailing Address
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Address Line | 4800 W 57TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108-2239
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Country | US
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Telephone | 605-323-3453
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Fax |
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Authorized Official
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Title or Position | VP, FINANCE
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Name | MR. JOEL FLUIT
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Credential |
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Telephone | 605-362-5416
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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 | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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