Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Good Samaritan Society - Lakota
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Authorized official
GEORGE GRANT TRIBBLE (EXECUTIVE VP)
(605) 362-3900
Entity
Organization
Contact information
Practice address
608 4TH AVE SW, LAKOTA, ND 58344-7500
(701) 247-2902
Mailing address
608 4TH AVE SW, LAKOTA, ND 58344-7500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000
MEDICARE PART B
—
Enumeration date
08/09/2018
Last updated
08/09/2018
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