NPIMap

Organization Active NPI

Professional Breathing Associates Inc

Doing business as Great Lakes Home Medical

  • Durable Medical Equipment & Medical Supplies
  • Iron River, MI
National Provider Identifier
1750351656
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PROFESSIONAL BREATHING ASSOCIATES INC
Doing business as
Great Lakes Home Medical
Practice address
4963 W US Highway 2
Iron River, MI 49935-7945
Phone
(906) 265-5985
Fax
(906) 265-0032
NPI assigned
Jan 24, 2006
Last updated
Apr 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ROTECH HEALTHCARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Authorized official

Name
Mrs. Robin L Menchen
Title
Chief Executive Officer
Phone
(407) 822-4600

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Customized Equipment (DME) 332BC3200X NU
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X NU
Oxygen Equipment & Supplies (DME) 332BX2000X NU
Prosthetic/Orthotic Supplier 335E00000X NU

Addresses

Primary practice location

4963 W US Highway 2
Iron River, MI 49935-7945

Mailing address

PO Box 27968
Salt Lake City, UT 84127-0968
Phone (765) 448-6685

Other identifiers 2

IdentifierTypeStateIssuer
3450572MedicaidMI
41748800MedicaidWI

Other names 1

  • GREAT LAKES HOME MEDICAL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930051244 MI DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 7214054915 Practice locations: Iron River, MI

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Professional Breathing Associates I4963 US Highway 2 West, Iron River, MI 49935-7945(906) 265-5985 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|External Infusion Pumps and/or Supplies|Ins… Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Professional Breathing Associates Inc8 organizations share this tax ID, including this one
Part of
Rotech Healthcare Inc

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1750351656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27968",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270968",
            "telephone_number": "765-448-6685",
            "fax_number": "765-446-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4963 W US HIGHWAY 2",
            "city": "IRON RIVER",
            "state": "MI",
            "postal_code": "499357945",
            "telephone_number": "906-265-5985",
            "fax_number": "906-265-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL BREATHING ASSOCIATES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROTECH HEALTHCARE INC",
        "enumeration_date": "2006-01-24",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "MENCHEN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "407-822-4600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3450572",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41748800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREAT LAKES HOME MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GREAT LAKES HOME MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Iron River, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.