| Lake Hospital System | |
|
29804 Lakeshore Blvd Willowick OH 44095 | |
| (440) 833-2095 | |
| (440) 833-2096 |
| Full Name | Lake Hospital System |
|---|---|
| Speciality | Family Medicine |
| Location | 29804 Lakeshore Blvd, Willowick, Ohio |
| Authorized Official Name and Position | Robert Tracz (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4403541051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Hospital System Po Box 714328 Columbus OH 43271-4328 Ph: (800) 354-1985 | Lake Hospital System 29804 Lakeshore Blvd Willowick OH 44095 Ph: (440) 833-2095 |
| NPI Number | 1326141987 |
|---|---|
| Provider Enumeration Date | 09/07/2006 |
| Last Update Date | 04/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326141987 | NPI | - | NPPES |
| 2694259 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35-084193 (Ohio) | Secondary |
| 208000000X | Pediatrics | 35-084193 (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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 | |
Lake Hospital System Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 29804 Lake Shore Blvd, Willowick, OH 44095 Phone: 440-585-3322 Fax: 440-585-1962 |