| Lake Hospital System, Inc. | |
|
2 Success Blvd. Perry OH 44081 | |
| (440) 375-8590 | |
| (440) 259-2106 |
| Full Name | Lake Hospital System, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2 Success Blvd., Perry, Ohio |
| Authorized Official Name and Position | Robert Tracz (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4403541642 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Hospital System, Inc. Po Box 714328 Columbus OH 43271-4328 Ph: (440) 375-8590 | Lake Hospital System, Inc. 2 Success Blvd. Perry OH 44081 Ph: (440) 375-8590 |
| NPI Number | 1174762512 |
|---|---|
| Provider Enumeration Date | 02/09/2009 |
| Last Update Date | 02/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174762512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Lake Hospital System Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Success Blvd, Perry, OH 44081 Phone: 440-375-8590 Fax: 440-259-2106 |