Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Good Samaritan Society- Pohai Nani, Harry and Jeannette Weinberg Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Authorized official
MS. ERIC VANDENHULL (CFO)
(605) 362-3100
Entity
Organization
Contact information
Practice address
45-090 NAMOKU ST, KANEOHE, HI 96744-5305
(808) 247-6211
(808) 247-9312
Mailing address
PO 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
—
0000049809
HMSA
HI
05
—
04462601
—
HI
01
—
43809
KAISER SENIOR ADVANTAGE
HI
Enumeration date
10/25/2005
Last updated
10/25/2021
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