Organization
LAKEWOOD HOSPITAL ASSOCIATION
Active
Other names
Lakewood Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN GLASS (CFO)
(216) 444-9361
Entity
Organization
Contact information
Practice address
14519 DETROIT AVE, LAKEWOOD, OH 44107-4316
(216) 521-4200
Mailing address
6801 BRECKSVILLE RD, SUITE 20 RK10, INDEPENDENCE, OH 44131-5032
(216) 636-8051
(216) 636-8088
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1134
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000233098
MEDICAL MUTUAL OF OHIO
OH
01
—
000000233098
ANTHEM
—
01
—
100748
KAISER
—
05
—
4923882
—
OH
01
—
521890
AETNA
—
05
—
760430
—
OH
Enumeration date
06/03/2006
Last updated
03/12/2009
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