Good Samaritan Society - Fennimore

LBN: The Evangelical Lutheran Good Samaritan Society
Good Samaritan Society - Fennimore is an health care organization with primary practice located at 1850 11Th St , Fennimore WI 53809-1612. 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 (608) 822-6100, or through Nylander, Raye Nae via phone (605) 362-3100.

Contact Information

Primary practice address
1850 11Th St Fennimore WI 53809-1612
Phone: (608) 822-6100
Fax: (608) 822-3011
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 1619958493
LBN Legal business name The Evangelical Lutheran Good Samaritan Society
DBA Doing business as Good Samaritan Society - Fennimore
Authorized official Nylander, Raye Nae
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 9th, 2005
Last updated Jan 17th, 2013 - about 12 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 1619958493 NPPES
Wisconsin MEDICAID 20150500
Wisconsin Other 542174

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