NPIMap

Organization Active NPI

Life Care Home Services of Northwestern Pennsylvania LLP

Doing business as Great Lakes Home Healthcare Services Pharmacy

  • Oxygen Equipment & Supplies (DME)
  • Erie, PA
National Provider Identifier
1851396022
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
3000008117 Issued in PA
Legal business name
LIFE CARE HOME SERVICES OF NORTHWESTERN PENNSYLVANIA LLP
Doing business as
Great Lakes Home Healthcare Services Pharmacy
Practice address
1700 Peach St
Ste 104
Erie, PA 16501-2134
Phone
(814) 877-6121
Fax
(814) 453-2440
NPI assigned
Jun 15, 2005
Last updated
Feb 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Authorized official

Name
Kathy Dubowski, RN, MSN
Title
President
Phone
(814) 877-6121

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 3000008117 PA
Durable Medical Equipment & Medical Supplies 332B00000X 22656 OH
Oxygen Equipment & Supplies (DME) 332BX2000X 3000008117 PA Primary
Prosthetic/Orthotic Supplier 335E00000X NU

Addresses

Primary practice location

1700 Peach St
Ste 104
Erie, PA 16501-2134

Mailing address

PO Box 641396
Pittsburgh, PA 15264-1396
Phone (814) 877-6121

Other names 1

  • GREAT LAKES HOME HEALTHCARE SERVICES PHARMACY Doing business as

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

600 Chestnut Street Ext
#3
Bradford, PA 16701
Phone (814) 362-8141

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1851396022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641396",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152641396",
            "telephone_number": "814-877-6121",
            "fax_number": "814-459-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PEACH ST",
            "address_2": "STE 104",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012134",
            "telephone_number": "814-877-6121",
            "fax_number": "814-453-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CARE HOME SERVICES OF NORTHWESTERN PENNSYLVANIA LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "DUBOWSKI",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-877-6121",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "3000008117",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "22656",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "PA",
            "license": "3000008117",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREAT LAKES HOME HEALTHCARE SERVICES PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.