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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 Ob/Gyn
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
36001 EUCLID AVE, SUITE C-7, WILLOUGHBY, OH 44094-4643
(440) 602-6710
(440) 602-8107
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(800) 354-1985
(440) 350-4938
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
06/15/2006
Last updated
09/06/2007
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