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Contact Information

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
8100 MEDICINE LAKE RD
NEW HOPE, MN55427-3404
 Phone: 763-544-4171
 Fax: 763-544-5526
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Facility Supplies

332BN1400X 87 All Other Suppliers
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

NPI Number 1114908878
LBN Legal business name THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Authorized official RAYE NAE NYLANDER - (CFO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 11/09/2005
Last updated 10/25/2021 - About 5 years ago
Identifiers
MN Medicaid 564214100
MN Other 5A05AM BLUE CROSS BLUE SHIELD
MN Other 32803 HEALTH PARTNERS
MN Other 7100087 MEDICA
MN Other 7111782 MEDICA CI
MN Other 01026658 PREFERRED ONE
MN Other NH001 UCARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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