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
303 CHESTNUT ST, MEADVILLE, PA 16335-3207
(814) 337-6900
(814) 337-6902
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
3000008116
PA
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
3000008116
PA
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007788280017
—
PA
Enumeration date
02/05/2007
Last updated
05/10/2012
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