Lifetime Medical Supply Inc.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

LIFETIME MEDICAL SUPPLY INC.

Practice address

1215 N Ottercreek Rd.
Streator, IL 61364

Phone

(815) 672-0670

NPI assigned

Aug 31, 2009

Last updated

Aug 31, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Rick Gelsthorpe

Title

President

Phone

(815) 672-0670

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251676800000",
    "number": "1497988984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 N OTTERCREEK RD.",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "61364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N OTTERCREEK RD.",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "61364",
            "telephone_number": "815-672-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME MEDICAL SUPPLY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A",
        "authorized_official_last_name": "GELSTHORPE",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-672-0670",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Thomas Kotecki
• Debra Kozsdiy
• Makenna Kramer, LAT, ATC
• Kroger Limited Partnership I (Kroger Pharmacy)
• Marci Lebowitz
• Linas a. Sidrys M.D.
• Rebecca Elizabeth Lucas-Simmons, PT
• Joan Marie Luckey, APRN,BC
• William C Malik, M.D.
• Jennifer Anne Malnar, LCSW, MSW

• Oxygen Equipment & Supplies (DME) in Streator, IL
• Providers in Streator, IL by specialty
• Oxygen Equipment & Supplies (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.