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1679563126

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
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332BN1400X	Nursing Facility Supplies (DME)
3	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1085	OTHER	KS	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679563126
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	:	2160 ZINNIA LN
Second Line	:
City	:	LIBERAL
State	:	KS
Zip	:	67901-2042
Country	:	US
Telephone Number	:	620-624-3832
Fax Number	:	620-624-2429

Authorized Official
Title or Position	:	CFO
Name	:	MS. JOEL FLUIT
Credential	:
Telephone Number	:	605-362-5416

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	11/20/2025

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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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