Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Good Samaritan Society - Glenwood Lakeview
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Authorized official
MS. RAYE NAE NYLANDER (CFO)
(605) 362-3100
Entity
Organization
Contact information
Practice address
515 FRANKLIN ST S, GLENWOOD, MN 56334-1545
(320) 634-4553
(320) 634-5109
Mailing address
4800 WEST 57TH STREET P.O. BOX 5038, SIOUX FALLS, SD 57117-5038
(605) 362-3100
(605) 362-3265
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031117013
PRIME WEST HEALTH
MN
05
—
050318500
—
MN
01
—
5A19LA
BLUE CROSS BLUE SHIELD
MN
01
—
7122582
MEDICA
MN
01
—
NH0197
UCARE
MN
Enumeration date
11/09/2005
Last updated
01/11/2013
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