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
195 E MAIN ST, BRADFORD, PA 16701-1619
(814) 362-8141
(814) 362-9113
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
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
8000002064
PA
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03011410
—
NY
05
—
1007788280016
—
PA
Enumeration date
02/05/2007
Last updated
07/27/2012
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