Good Samaritan Society - Peoria Good Shepherd

LBN: The Evangelical Lutheran Good Samaritan Society
Good Samaritan Society - Peoria Good Shepherd is an health care organization with primary practice located at 10323 W Olive Ave , Peoria AZ 85345-7345. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Skilled Nursing Facility, Suppliers / Nursing Facility Supplies, Suppliers / Parenteral & Enteral Nutrition. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. The Evangelical Lutheran Good Samaritan Society can be contacted via phone (623) 875-0100, or through Nylander, Raye Nae via phone (605) 362-3100.

Contact Information

Primary practice address
10323 W Olive Ave Peoria AZ 85345-7345
Phone: (623) 875-0100
Fax: (623) 875-0110
Website:
Map and Directions
Authorized official contact:
Name: Nylander, Raye Nae
Phone: (605) 362-3100

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X
Suppliers / Nursing Facility Supplies 332BN1400X
Suppliers / Parenteral & Enteral Nutrition 332BP3500X

Profile Details

NPI number 1205826922
LBN Legal business name The Evangelical Lutheran Good Samaritan Society
DBA Doing business as Good Samaritan Society - Peoria Good Shepherd
Authorized official Nylander, Raye Nae
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 25th, 2005
Last updated Dec 27th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205826922 NPPES
Arizona Other 7100002 EVERCARE M/C
Arizona MEDICAID 04044401 EVERCARE M/C

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