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Organization

LAKE HOSPITAL SYSTEM, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL KITTOE (CFO)
(440) 354-1051
Entity
Organization

Contact information

Practice address
36000 EUCLID AVE, WILLOUGHBY, OH 44094-4625
(440) 953-9600
Mailing address
7590 AUBURN RD, CONCORD TWP, OH 44077-9176
(440) 375-8100

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
360098
MEDICARE
05
4922507
OH
Enumeration date
06/22/2011
Last updated
06/22/2011
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