| Organization Name: | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| NPI Number: | 1114908878 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAYE NAE NYLANDER (CFO) |
| Mailing Address: | 8100 Medicine Lake Rd New Hope |
| State: | MN US |
| Postal Code: | 554273404 |
| Phone Number: | 7635444171 |
| Fax Number: | 7635445526 |
| NPI Enumeration Date: | 11/09/2005 |
| NPI Last Update Date: | 12/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |