Organization · Type 2 NPI

The Evangelical Lutheran Good Samaritan Society

Skilled Nursing Facility · Daytona Beach, FL

NPI number 1962484022 Active

Practice location

325 S Segrave St
Daytona Beach, FL 32114-4220

Call (386) 253-6791 Map

Fax (386) 258-3842

Mailing address

PO Box 5038
Sioux Falls, SD 57117-5038

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	None listed
Nursing Facility Supplies (DME)	332BN1400X	None listed
Parenteral & Enteral Nutrition Supplies (DME)	332BP3500X	None listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

5 other providers at this address

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NPI record

NPI: 1962484022
Entity type: Organization (Type 2)
Issued: Nov 15, 2005
Last updated: Oct 25, 2021
Status: Active
Subpart: Yes of The Evangelical Lutheran Good Samaritan Society

Other names

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Good Samaritan Society - Daytona · doing business as
Good Samaritan Society - Daytona · doing business as

Authorized official

Mr. Eric Vanden Hull
VP, Finance
(605) 362-3100

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1962484022

The Evangelical Lutheran Good Samaritan Society's National Provider Identifier is 1962484022, issued on Nov 15, 2005. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Daytona Beach, FL. The record was last updated on Oct 25, 2021.