Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Good Samaritan Society - Windom
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
705 6TH ST, WINDOM, MN 56101-1814
(507) 831-1788
(507) 831-0844
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
—
4350SO
PMAP BLUE PLUS
MN
01
—
4530SO
BLUE CROSS BLUE SHIELD
MN
05
—
677840200
—
MN
01
—
7100226
PMAP EVERCARE
MN
01
—
7122578
MEDICA
MN
01
—
NH0235
UCARE OF MN
MN
Enumeration date
11/09/2005
Last updated
11/28/2021
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