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Organization

LORAIN COUNTY HEALTH & DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA M HEMKER CFO (CREDENTIALINGLORAINHEALTH-DENTISTRY)
(440) 240-1655
Entity
Organization

Contact information

Practice address
6150 PARK SQUARE DR., LORAIN, OH 44053-4153
(440) 240-1655
(440) 240-1655
Mailing address
1205 BROADWAY AVE, LORAIN, OH 44052-3409
(440) 240-1655
(440) 240-1663

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207QA0505X
Adult Medicine Physician
207R00000X
Internal Medicine Physician
OH
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
OH
363L00000X
Nurse Practitioner
363LA2200X
Adult Health Nurse Practitioner
363LF0000X
Family Nurse Practitioner
363LP2300X
Primary Care Nurse Practitioner

Other

Enumeration date
08/29/2016
Last updated
08/14/2019
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