Organization
LIFE CARE HOME SERVICES OF NORTHWESTERN PENNSYLVANIA LLP
Active
Other names
Great Lakes Home Healthcare Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY L DUBOWSKI RN, MSN (PRESIDENT)
(814) 877-6121
Entity
Organization
Contact information
Practice address
1700 PEACH ST, STE 104, ERIE, PA 16501-2134
(814) 877-6121
(814) 877-3027
Mailing address
1647 SASSAFRAS ST, ERIE, PA 16502-1858
(814) 877-6121
(814) 459-1858
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007788280012
—
PA
05
—
1007788280018
—
PA
Enumeration date
04/24/2008
Last updated
03/17/2011
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