Organization
LAKE SHORE HMA, LLC
Active
Parent organization
LAKE SHORE HMA, LLC
Other names
Shands Lake Shore Regional Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE SHORE HMA, LLC
Authorized official
PAULA LALOR (DIRECTOR/ DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
368 NE FRANKLIN ST, LAKE CITY, FL 32055-3088
(386) 292-8000
(386) 795-8369
Mailing address
368 NE FRANKLIN ST, LAKE CITY, FL 32055-3088
(386) 292-8000
(386) 795-8369
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
4268
FL
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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