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Organization

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Good Samaritan Society - Denton Village
Organization subpart
Yes

Provider details

NPI number
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Authorized official
MR. JOEL FLUIT (VP, FINANCE)
(605) 362-5416
Entity
Organization

Contact information

Practice address
2500 HINKLE DR, DENTON, TX 76201-0739
(940) 383-2651
(940) 382-9306
Mailing address
4800 W 57TH ST, SIOUX FALLS, SD 57108-2239
(605) 323-3453

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
05
000509801
TX
01
0140910110
MEDICARE NSC
TX
01
455627
MEDICARE OSCAR/CERTIFICATION
TX
Enumeration date
11/04/2005
Last updated
09/02/2025
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