Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Good Samaritan Society - Wymore
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Authorized official
MRS. RAYE NAE NYLANDER (CFO)
(605) 362-3100
Entity
Organization
Contact information
Practice address
105 E D ST, WYMORE, NE 68466-2151
(402) 645-3355
(402) 645-3497
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
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00652
BLUE CROSS BLUE SHIELD
NE
01
—
F248083
MIDLANDS CHOICE
NE
Enumeration date
11/03/2005
Last updated
01/17/2013
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