Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Good Samaritan Society - Pelican Rapids
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
119 N BROADWAY, PELICAN RAPIDS, MN 56572-0646
(218) 863-2401
(218) 863-5049
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
05
—
277242600
—
MN
01
—
7122575
MEDICA
MN
01
—
9529GO
BLUE CROSS BLUE SHIELD
MN
Enumeration date
11/08/2005
Last updated
12/27/2012
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