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Organization
LAKE HOSPITAL SYSTEM
Active
Organization
LAKE HOSPITAL SYSTEM
Active
Other names
LHPG Thomas Mentor Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
RICK CICERO (SR. VP BUSINESS DEVELOPMENT)
(440) 354-1739
Entity
Organization
Contact information
Practice address
8316 YELLOWBRICK RD, MENTOR, OH 44060-4960
(440) 205-8818
(440) 974-1794
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(440) 205-8818
(440) 974-1794
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/17/2011
Last updated
08/17/2011
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