NPIMap

Organization Active NPI

Great Lakes Medical Services LLC

  • Durable Medical Equipment & Medical Supplies
  • Perrysburg, OH
National Provider Identifier
1922248863
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
GREAT LAKES MEDICAL SERVICES LLC
Practice address
25660 Dixie Hwy
Perrysburg, OH 43551-2167
Phone
(419) 872-5343
Fax
(419) 872-7464
NPI assigned
Mar 5, 2009
Last updated
Mar 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

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

Authorized official

Name
Evan Kyle Prueter
Title
President
Phone
(419) 872-5343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

25660 Dixie Hwy
Perrysburg, OH 43551-2167

Mailing address

25660 Dixie Hwy
Perrysburg, OH 43551-2167
Phone (419) 872-5343

National Provider Directory

National Provider Directory
Tax ID family
Great Lakes Medical Services Dba Great Lakes Urgent Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1236211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236211200000",
    "number": "1922248863",
    "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 MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-05",
        "last_updated": "2009-03-05",
        "status": "A",
        "authorized_official_last_name": "PRUETER",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-872-5343"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.