MEDICARE: GREAT LAKES MEDICAL EQUIPMENT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	540C80499	OTHER	MI	BLUE CROSS BLUE SHIELD MI
3	1431	OTHER	MI	NORTHWOOD, INC.
4	57478	OTHER	MI	NORTHWOOD NPN
5	XX20420	OTHER	MI	HEALTHPLUS OF MI

General Provider Information

NPI Number	:	1578564852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREAT LAKES MEDICAL EQUIPMENT, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1402
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49204
Country	:	US
Telephone Number	:	517-536-7350
Fax Number	:	517-536-0671

Provider Business Practice Location Address
First Line	:	209 E WASHINGTON AVE STE 254
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-2393
Country	:	US
Telephone Number	:	517-536-7350
Fax Number	:	517-536-0671

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	COLLEEN SHAUGHNESSY ANDERSON
Credential	:
Telephone Number	:	517-536-7350

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	10/31/2024

Similar Medicare Providers

1588642110 — GREAT LAKES HOME HEALTH SERVICES, INC.
Practice Location Address:

209 E WASHINGTON AVE STE 450
JACKSON, MI
49201-2393

Practice Phone: 517-780-9500
Practice Fax: 517-780-9700

1568440055 — GREAT LAKES HOME HEALTH SERVICES, INC.
Practice Location Address:

209 W. WASHINGTON STE. 450A
JACKSON, MI
49201-2393

Practice Phone: 517-435-3055
Practice Fax: 517-780-9700

1952988370 — GREAT LAKES HOME HEALTH SERVICES, INC.
Practice Location Address:

209 E WASHINGTON AVE STE 450A
JACKSON, MI
49201-2393

Practice Phone: 517-780-9500
Practice Fax: 517-780-9700

1306957444 — JACKSON BEHAVIORAL SERVICES
Practice Location Address:

209 E WASHINGTON AVE , SUITE 221
JACKSON, MI
49201-2393

Practice Phone: 517-780-0809
Practice Fax: 517-788-5922

1629244033 — BRADFORD J BANDEMER
Practice Location Address:

209 E WASHINGTON AVE , SUITE 220
JACKSON, MI
49201-2393

Practice Phone: 517-782-0100
Practice Fax: 517-782-1195

1063650414 — RAMONA SUE WRIGHT L.P.C.
Practice Location Address:

209 E WASHINGTON AVE , SUITE 219 BOX 6
JACKSON, MI
49201-2393

Practice Phone: 517-262-0571
Practice Fax: 866-904-2399

Directions to “GREAT LAKES MEDICAL EQUIPMENT, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.