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THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Parenteral and Enteral Nutrition

Clear Lake, South Dakota

Provider NPI: 1861474330

Organization Information:
Organization Name:  THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY


Practice Location:
913 COL PETE ST S  CLEAR LAKE, SD 57226 US
Tel: 605-874-2159  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N332BN1400XSuppliers
Durable Medical Equipment & Medical Supplies
Nursing Facility Supplies
N332BP3500XSuppliers
Durable Medical Equipment & Medical Supplies
Y314000000XNursing & Custodial Care Facilities
Skilled Nursing Facility

Other Provider Identifiers:

IssuerNumberStateType
BLUE CROSS BLUE SHIELD85117SD01
0150290SD05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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