Organization
LAKE HOSPITAL SYSTEM INC
Active
Other names
Prime Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KITTOE (CFO)
(440) 354-1985
Entity
Organization
Contact information
Practice address
6067 N RIDGE RD, MADISON, OH 44057-2441
(440) 417-0002
(440) 417-0020
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(440) 354-1985
(440) 350-4938
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/06/2011
Last updated
09/26/2011
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