Organization
LORAIN COUNTY HEALTH & DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA WASHINGTON (CREDENTIALING SPECIALIST)
(440) 240-1655
Entity
Organization
Contact information
Practice address
801 MIDDLE AVE., ELYRIA, OH 44035-5850
(440) 240-1655
(440) 240-1663
Mailing address
1205 BROADWAY AVE, LORAIN, OH 44052-3409
(440) 240-1655
(440) 240-1663
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0441628
—
OH
Enumeration date
11/28/2012
Last updated
06/24/2021
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