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Organization
LAKE HOSPITAL SYSTEM INC
Active
Organization
LAKE HOSPITAL SYSTEM INC
Active
Other names
Prime Health Perry Health and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KITTOE (CFO)
(440) 354-1085
Entity
Organization
Contact information
Practice address
2 SUCCESS BLVD, PERRY, OH 44081-9404
(440) 375-8590
(440) 259-2106
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(440) 354-1985
(440) 350-4938
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
NULL
Other
Enumeration date
02/18/2011
Last updated
06/22/2011
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