# THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- **Other names:** Good Samaritan Society - Dodge City
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356331870
- **Legal business name:** THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- **Authorized official:** MS. RAYE NAE NYLANDER (CFO)
- **Authorized official phone:** (605) 362-3100

## Contact information

- **Practice address:** 501 W BEESON RD, DODGE CITY, KS 67801-5915
- **Practice address phone:** (620) 227-7512
- **Practice address fax:** (620) 227-6303
- **Mailing address:** PO BOX 5038, SIOUX FALLS, SD 57117-5038
- **Mailing address phone:** (605) 362-3100
- **Mailing address fax:** (605) 362-3265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | — | — | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | — | — |

## Other

- **Enumeration date:** 10/26/2005
- **Last updated:** 12/27/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100109120A | — | KS |
| 01 | — | 92 | BLUE CROSS BLUE SHIELD | KS |