Organization Name: | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
NPI Number: | 1235110016 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RAYE NAE NYLANDER (CFO) |
Mailing Address: | 23926 4th Ave S Siren |
State: | WI US |
Postal Code: | 548728334 |
Phone Number: | 7153492292 |
Fax Number: | 7153497218 |
NPI Enumeration Date: | 11/09/2005 |
NPI Last Update Date: | 11/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BN1400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Nursing Facility Supplies |
Taxonomy Definition: |