Organization
LORAIN COUNTY HEALTH & DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M. HEMKER (CFO)
(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, LORAIN, OH 44052-3409
(440) 240-1655
(440) 245-1218
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
213E00000X
Podiatrist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0086523
—
OH
Enumeration date
11/27/2012
Last updated
06/24/2021
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