| Lake Hospital System Inc. | |
|
29804 Lake Shore Blvd Willowick OH 44095-4611 | |
| (440) 585-3322 | |
| (440) 585-1962 |
| Full Name | Lake Hospital System Inc. |
|---|---|
| Speciality | Clinic/center - Urgent Care |
| Location | 29804 Lake Shore Blvd, Willowick, Ohio |
| Authorized Official Name and Position | Bob Tracz (CFO) |
| Authorized Official Contact | 4403541953 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Hospital System Inc. Po Box 781348 Detroit MI 48278-1348 Ph: (800) 354-1895 | Lake Hospital System Inc. 29804 Lake Shore Blvd Willowick OH 44095-4611 Ph: (440) 585-3322 |
| NPI Number | 1912967209 |
|---|---|
| Provider Enumeration Date | 03/23/2006 |
| Last Update Date | 02/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912967209 | NPI | - | NPPES |
| 264200001 | Other | OH | DEPT OF LABOR |
| 80507 | Other | OH | QUALCHOICE |
| 2017301 | Medicaid | OH | |
| 264200001 | Other | OH | FEDERAL BLACK LUNG |
| 6600162 | Other | OH | UNITED HEALTHCARE |
| 2440148 | Medicaid | OH |
Lake Hospital System Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 29804 Lakeshore Blvd, Willowick, OH 44095 Phone: 440-833-2095 Fax: 440-833-2096 | |
Lake Hospital System, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 29804 Lakeshore Blvd, Willowick, OH 44095 Phone: 440-354-1899 Fax: 440-354-1089 | |
Cielo Vitality Health & Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 36336 Vine St, Suite 100, Willowick, OH 44095 Phone: 216-261-6398 Fax: 216-261-6398 |