Good Samaritan Society - Daytona

LBN: The Evangelical Lutheran Good Samaritan Society
Good Samaritan Society - Daytona is an health care organization with primary practice located at 325 S Segrave St , Daytona Beach FL 32114-4220. 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 (386) 253-6791, or through Vanden Hull, Eric via phone (605) 362-3100.

Contact Information

Primary practice address
325 S Segrave St Daytona Beach FL 32114-4220
Phone: (386) 253-6791
Fax: (386) 258-3842
Website:
Map and Directions
Authorized official contact:
Name: Vanden Hull, Eric
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 1962484022
LBN Legal business name The Evangelical Lutheran Good Samaritan Society
DBA Doing business as Good Samaritan Society - Daytona
Authorized official Vanden Hull, Eric
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 15th, 2005
Last updated Oct 25th, 2021 - about 3 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 1962484022 NPPES
Florida Other 141221300 MEDICAID ALF OSS
Florida Other 7100409 MEDICAID ALF OSS
Florida MEDICAID 675714601 MEDICAID ALF OSS
Florida MEDICAID 020439100 MEDICAID ALF OSS
Florida Other K2S MEDICAID ALF OSS

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