Organization
LAKE HOSPITAL SYSTEM, INC
Active
Organization
LAKE HOSPITAL SYSTEM, INC
Active
Other names
Lake Health Walk In Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT TRACZ (CFO)
(440) 354-1952
Entity
Organization
Contact information
Practice address
74 S PARK PLACE, PAINESVILLE, OH 44077
(440) 354-3887
(440) 354-4071
Mailing address
PO BOX 781348, DETROIT, MI 48278-1348
(440) 354-3887
(440) 354-4071
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2017301
—
OH
Enumeration date
10/15/2009
Last updated
02/17/2017
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