NPIMap

Organization Active NPI

Life Care Home Services of Northwestern Pennsylvania LLP

Doing business as Great Lakes Home Healthcare Services

  • Oxygen Equipment & Supplies (DME)
  • Bradford, PA
National Provider Identifier
1972641496
Registry record updated Jul 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
8000002064 Issued in PA
Legal business name
LIFE CARE HOME SERVICES OF NORTHWESTERN PENNSYLVANIA LLP
Doing business as
Great Lakes Home Healthcare Services
Practice address
195 E Main St
Bradford, PA 16701-1619
Phone
(814) 362-8141
Fax
(814) 362-9113
NPI assigned
Feb 5, 2007
Last updated
Jul 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2012

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Oxygen Equipment & Supplies (DME) 332BX2000X 8000002064 PA Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

195 E Main St
Bradford, PA 16701-1619

Mailing address

1647 Sassafras St
Erie, PA 16502-1858
Phone (814) 877-6121

Other identifiers 2

IdentifierTypeStateIssuer
1007788280016MedicaidPA
03011410MedicaidNY

Other names 1

  • Great Lakes Home Healthcare Services 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.

Member organizations 8

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343347200000",
    "number": "1972641496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 SASSAFRAS ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165021858",
            "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": "195 E MAIN ST",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011619",
            "telephone_number": "814-362-8141",
            "fax_number": "814-362-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CARE HOME SERVICES OF NORTHWESTERN PENNSYLVANIA LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2012-07-27",
        "status": "A",
        "authorized_official_last_name": "DUBOWSKI",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-877-6121",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "PA",
            "license": "8000002064",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007788280016",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03011410",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Home Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bradford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.