| Lake Hospital System Inc | |
|
36000 Euclid Ave Willoughby OH 44094-4662 | |
| (440) 953-9600 | |
| (440) 953-6081 |
| Full Name | Lake Hospital System Inc |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 36000 Euclid Ave, Willoughby, Ohio |
| Authorized Official Name and Position | Anthony Schrillero (DIRECTOR OF FINANCIAL PLANNING) |
| Authorized Official Contact | 2167678141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Hospital System Inc Po Box 772930 Detroit MI 48277-2930 Ph: (440) 953-9600 | Lake Hospital System Inc 36000 Euclid Ave Willoughby OH 44094-4662 Ph: (440) 953-9600 |
| NPI Number | 1972689172 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 03/18/2025 |
| Certification Date | 03/18/2025 |
| Medicare PECOS PAC ID | 6002713922 |
|---|---|
| Medicare Enrollment ID | O20080112000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972689172 | NPI | - | NPPES |
| 0140D446 | Medicaid | KY | |
| 807020000 | Medicaid | ID | |
| 816807662A | Medicaid | GA | |
| XHSP33687 | Medicaid | CA | |
| 10024977600 | Medicaid | NE | |
| XHSP43687 | Medicaid | CA | |
| 016066904 | Medicaid | MT | |
| 803272 | Medicaid | AZ | |
| 909509800 | Medicaid | FL | |
| 0011437050002 | Medicaid | PA | |
| 4922507 | Medicaid | OH | |
| D2490320 | Medicaid | NY | |
| LAK0098N | Medicaid | AL | |
| 3600098 | Medicaid | NC |
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