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Organization

LAKESHORE COMMUNITY HOSPITAL, INC.

Active
Parent organization
LAKESHORE COMMUNITY HOSPITAL, INC.
Other names
Shelby Family Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
LAKESHORE COMMUNITY HOSPITAL, INC.
Authorized official
MRS. COLLEEN JOHNSON CMPE FABC (CLINIC MANAGER)
(231) 861-2172
Entity
Organization

Contact information

Practice address
71 BEVIER ST, SHELBY, MI 49455-1239
(231) 861-2172
(231) 861-5100
Mailing address
71 BEVIER ST, SHELBY, MI 49455-1239
(231) 861-2172
(231) 861-5100

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0F41037
BCBSM
MI
Enumeration date
08/22/2011
Last updated
08/22/2011
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