Provider Demographics
NPI:1316018021
Name:ALLIED ORTHOPEDIC APPLIANCES INC.
Entity Type:Organization
Organization Name:ALLIED ORTHOPEDIC APPLIANCES INC.
Other - Org Name:GREAT LAKES HOME HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUBOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:814-877-6121
Mailing Address - Street 1:1647 SASSAFRAS ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-1858
Mailing Address - Country:US
Mailing Address - Phone:814-877-6121
Mailing Address - Fax:814-459-1858
Practice Address - Street 1:37 W MAIN ST
Practice Address - Street 2:LOWER STE
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063-2135
Practice Address - Country:US
Practice Address - Phone:716-672-4704
Practice Address - Fax:716-672-4706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8208101OtherIHA
NY10325460OtherFIDELIS
NY000000076933OtherGHI
NY00011204301OtherUNIVERA
NY02769799Medicaid
NY0551090001OtherBC AND BS OF WNY
NY00011204301OtherUNIVERA
NY0484840003Medicare ID - Type Unspecified