Great Lakes Nursing LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GREAT LAKES NURSING LLC

Practice address

25660 Dixie Hwy
Perrysburg, OH 43551-2167

Phone

(419) 872-5343

Fax

(419) 872-7464

NPI assigned

Feb 6, 2008

Last updated

Sep 30, 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

Evan Kyle Prueter

Title

Ceo

Phone

(419) 872-5343

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1770761272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25660 DIXIE HWY",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512167",
            "telephone_number": "419-872-5343",
            "fax_number": "419-872-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25660 DIXIE HWY",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512167",
            "telephone_number": "419-872-5343",
            "fax_number": "419-872-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES NURSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "PRUETER",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-872-5343"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Great Lakes Medical Services LLC
• Christina Michelle Green, MA
• Henry B Green, DPM
• Rimple Grewal, DMD
• Grewaldental Care LLC
• McKayla Cheyanne Griffith

• Home Health Agency in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.