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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
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2F248086OTHERIAMIDLANDS CHOICE
365169OTHERIABLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1841280476
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 : 700 WAVERLY RD
Second Line :
City : DAVENPORT
State : IA
Zip : 52804-4317
Country : US
Telephone Number : 563-324-1651
Fax Number : 563-336-3963
Authorized Official
Title or Position : CFO
Name : MS. RAYE NAE NYLANDER
Credential :
Telephone Number : 605-362-3100
Provider Enumeration Date : 10/25/2005
Last Update Date : 10/25/2021

Similar Medicare Providers

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Practice Location Address:
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1407091234 — MRS. ERIKA LYNN ADAMSON COTA/L
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1730516485 — MRS. DEANNA L AXTELL PTA
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Practice Fax:
1033546783 — DR. CRESENCIA JENE BURHANS OTR/L
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1740617406 — LISA MARIE GARLOCK PTA
Practice Location Address:
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1265869713 — HOLLE AHNA MARICLE M.A., CCC-SLP
Practice Location Address:
700 WAVERLY RD
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Practice Phone: 563-324-1651
Practice Fax: 563-324-1651

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

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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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