Great Lakes Medical Supply Network LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GREAT LAKES MEDICAL SUPPLY NETWORK LLC

Practice address

4066 Stilmore Rd
South Euclid, OH 44121-2615

Phone

(216) 355-4639

NPI assigned

Jul 9, 2026

Organization subpart

No

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

Authorized official

Name

Mrs. Serita Clay

Title

President

Phone

(216) 355-4639

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1783555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1396663860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4066 STILMORE RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441212615",
            "telephone_number": "216-355-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4066 STILMORE RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441212615",
            "telephone_number": "216-355-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES MEDICAL SUPPLY NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-09",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "SERITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-355-4639",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Duncan Grant, MD
• Jaque D Grant, RN
• Nakia Graves, LPN
• Jacqueline Gray
• Tiffany Nicole Grays-White
• Green Road Pediatrics, Inc.
• Deangelo Green
• Grime Fighters
• Grime Fighters for Kids Company
• Jabrile Grimes

• Durable Medical Equipment & Medical Supplies in South Euclid, OH
• Providers in South Euclid, 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 Jul 9, 2026; 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.