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Organization

LAKE HOSPITAL SYSTEM INC

Active
Parent organization
LAKE HOSPITAL SYSTEM, INC.
Other names
PrimeHealth Womens Health Specialists
Organization subpart
Yes

Provider details

NPI number
Legal business name
LAKE HOSPITAL SYSTEM, INC.
Authorized official
MR. ROBERT TRACZ (CHIEF FINANCIAL OFFICER)
(440) 354-1051
Entity
Organization

Contact information

Practice address
35040 CHARDON RD, BLDG VII #205, WILLOUGHBY HILLS, OH 44094
(440) 918-4630
(440) 918-4632
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(800) 354-1985
(440) 350-4938

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2111100
OH
Enumeration date
06/15/2006
Last updated
09/06/2007
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