Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Good Samaritan Society - Comforcare
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
1201 17TH ST NE, AUSTIN, MN 55912-4013
(507) 437-4526
(507) 437-9024
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
—
1026597
PREFERRED ONE
MN
01
—
5A12CO
BLUE CROSS BLUE SHIELD
MN
05
—
692515400
—
MN
01
—
7100171
MEDICA CHOICE
MN
01
—
NH0484
UCARE
MN
Enumeration date
11/11/2005
Last updated
10/25/2021
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