NPI 1366432023
The Evangelical Lutheran Good Samaritan Society
Practice location
- Address
- 840 E Elva St, Idaho Falls, ID 83401-2801
- Phone
- (208) 523-4795
- Fax
- (208) 522-9175
- Mailing address
- PO Box 5038, Sioux Falls, SD 57117-5038
Authorised official
- Name
- Raye Nae Nylander
- Title
- Cfo
- Phone
- (605) 362-3100
Registered specialties (3)
Skilled Nursing Facility
Primary
Nursing Facility Supplies (DME)
Parenteral & Enteral Nutrition Supplies (DME)
Registry record
- NPI
- 1366432023
- Entity type
- Organization
- NPI issued
- 25 Oct 2005
- Record last updated
- 25 Oct 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.