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Organization
LAKE HOSPITAL SYSTEM INC
Active
Organization
LAKE HOSPITAL SYSTEM INC
Active
Parent organization
LAKE HOSPITAL SYSTEM, INC.
Other names
PrimeHealth Family Practice Mentor
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE HOSPITAL SYSTEM, INC.
Authorized official
MR. ROBERT TRACZ (CHIEF FINANCIAL OFFICER)
(440) 354-1051
Entity
Organization
Contact information
Practice address
6990 LINDSAY DR, #3, MENTOR, OH 44060-4981
(440) 255-7938
(440) 255-9196
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(800) 354-1985
(440) 350-4938
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/11/2006
Last updated
09/06/2007
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