GREEN LAKE MEDICAL SUPPLY, INC
NPI 1740401017
Durable Medical Equipment & Medical Supplies in Grosse Pointe Farms, MI

Q: What is Green Lake Medical Supply, Inc's NPI number?

The NPI number for Green Lake Medical Supply, Inc is 1740401017. It was assigned to this organization in the NPPES registry on May 2, 2007.

Q: What is Green Lake Medical Supply, Inc's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Active since May 02, 2007

93 KERCHEVAL AVE, GROSSE POINTE FARMS, MI 48236(313) 882-3900(313) 882-3947 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

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About Green Lake Medical Supply, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREEN LAKE MEDICAL SUPPLY, INC (NPI 1740401017) is a healthcare organization registered as a durable medical equipment & medical supplies in Grosse Pointe Farms, Michigan and active in the NPI registry since May 2007. The organization lists Robert Lee Moorhead, President, as its authorized official.

NPPES Registry Identity

NPI1740401017

Entity TypeOrganization

Primary Taxonomy332B00000X

Legal Business NameGREEN LAKE MEDICAL SUPPLY, INC

Location Address93 KERCHEVAL AVEGrosse Pointe Farms, MI 48236-3600

Mailing Address18530 Mack Ave Ste 411Grosse Pointe Farms, MI 48236-3254 · (313) 882-3900 · Fax (313) 882-3947

Phone(313) 882-3900

Fax(313) 882-3947

Organization SubpartNo

Authorized OfficialRobert Lee MoorheadPresident · (313) 882-3900

Enumeration DateMay 2, 2007

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1740401017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

93 KERCHEVAL AVE, Grosse Pointe Farms, MI 48236

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Other Identifiers 1

Medicaid3141989MI

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Green Lake Medical Supply, Inc's NPI number?

The NPI number for Green Lake Medical Supply, Inc is 1740401017. It was assigned to this organization in the NPPES registry on May 2, 2007.

Where is Green Lake Medical Supply, Inc located?

Green Lake Medical Supply, Inc is located at 93 Kercheval Ave, Grosse Pointe Farms, MI 48236. The listed phone number is (313) 882-3900.

What is Green Lake Medical Supply, Inc's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Green Lake Medical Supply, Inc was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.