# ST MARGARET MERCY HEALTHCARE CENTERS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Ridge Occupational Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689746000
- **Authorized official:** THOMAS GRYZBEK (PRESIDENT)
- **Authorized official phone:** (219) 932-2300

## Contact information

- **Practice address:** 1573 N CLINE AVE, GRIFFITH, IN 46319-1567
- **Practice address phone:** (219) 838-2312
- **Practice address fax:** (219) 838-1521
- **Mailing address:** PO BOX 1000, DYER, IN 46311-0800
- **Mailing address phone:** (219) 864-2107
- **Mailing address fax:** (219) 864-2251

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 06/23/2008