1851373294 NPI number — THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Table of content: (NPI 1851373294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851373294 NPI number — THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
GOOD SAMARITAN SOCIETY HOME HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851373294
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5038
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIOUX FALLS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57117-5038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-362-3100
Provider Business Mailing Address Fax Number:
605-362-3265

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4075 TIMBERLINE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND ISLAND
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68803-6553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-382-4054
Provider Business Practice Location Address Fax Number:
308-382-4033
Provider Enumeration Date:
11/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FLUIT
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT, FINANCE
Authorized Official Telephone Number:
605-362-5416

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 226 . This is a "THE VILLA" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 213 . This is a "PRIVATE PAY" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 1851373294 . This is a "NPI" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com