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Contact Information

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
23926 4TH AVE S
SIREN, WI54872-8334
 Phone: 715-349-2292
 Fax: 715-349-7218
 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
Indicates primary specialty

NPI Profile & details for THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

NPI # 1235110016
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 11/09/2007 - About 19 years ago
Identifiers
WI Medicaid 20158900
WI Other 9840CA BLUE CROSS BLUE SHIELD
WI Other 7122742 MEDICA
WI Other 1026758 PREFERRED ONE - INPATIENT
WI Other 1014259 PREFERRED ONE - THERAPY
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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