Organization
GREAT LAKES MEDICAL EQUIPMENT, INC.
Active
Organization
GREAT LAKES MEDICAL EQUIPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN SHAUGHNESSY ANDERSON (VICE PRESIDENT)
(517) 536-7350
Entity
Organization
Contact information
Practice address
209 E WASHINGTON AVE STE 254, JACKSON, MI 49201-2393
(517) 536-7350
(517) 536-0671
Mailing address
PO BOX 1402, JACKSON, MI 49204
(517) 536-7350
(517) 536-0671
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1431
NORTHWOOD, INC.
MI
05
—
2889073
—
MI
01
—
540C80499
BLUE CROSS BLUE SHIELD MI
MI
01
—
57478
NORTHWOOD NPN
MI
01
—
XX20420
HEALTHPLUS OF MI
MI
Enumeration date
08/09/2005
Last updated
10/31/2024
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