Great Lakes Neurotechnologies Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GREAT LAKES NEUROTECHNOLOGIES INC

Practice address

6100 Rockside Woods Blvd N Ste 415
Cleveland, OH 44131-2339

Phone

(216) 361-5410

Fax

(216) 361-5420

NPI assigned

May 20, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew Tarler

Title

Director Quality & Regulatory

Phone

(216) 361-5410

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1194382721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 ROCKSIDE WOODS BLVD N STE 415",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441312339",
            "telephone_number": "216-361-5410",
            "fax_number": "216-361-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 ROCKSIDE WOODS BLVD N STE 415",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441312339",
            "telephone_number": "216-361-5410",
            "fax_number": "216-361-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES NEUROTECHNOLOGIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "TARLER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR QUALITY & REGULATORY",
        "authorized_official_telephone_number": "216-361-5410"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lequan Grayson
• Ramona Lynn Grayson
• Michelle Grdina
• Madison Greany
• Great Global Home Health Care Service LLC
• Great Lakes Senior Home Care
• Greatcare Home Health
• Greater Cleveland Dermatology Group Inc
• Denee D. Greathouse
• Sharria Greathouse

• Durable Medical Equipment & Medical Supplies in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Durable Medical Equipment & Medical Supplies in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.