THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Parenteral and Enteral Nutrition
Crosby, North Dakota
Provider NPI: 1740261858
Organization Information:Organization Name: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Practice Location:
705 4TH ST SE CROSBY, ND 58730 US
Tel: 701-965-6086 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
705 4TH ST SE CROSBY, ND 58730 US
Tel: 701-965-6086 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 332BP3500X | Suppliers Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | ||
N | 332BN1400X | Suppliers Durable Medical Equipment & Medical Supplies | ||
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
BLUE CROSS BLUE SHIELD | 8185 | ND | 01 |
30122 | ND | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin