Organization
LAKE HOSPITAL SYSTEM INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT TRACZ (CFO)
(440) 354-1051
Entity
Organization
Contact information
Practice address
7590 AUBURN RD, CONCORD TWP, OH 44077-9176
(440) 375-8152
(440) 354-1245
Mailing address
PO BOX 781348, DETROIT, MI 48278
(800) 354-1985
(440) 354-4938
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/18/2006
Last updated
07/21/2022
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