Lake Hospital System INC

NPI #1417991332 in Willoughby, Ohio

Provider Information

NPI Number: 1417991332
Entity Type: Organization
Organization Name: Lake Hospital System INC
Subpart: Yes (part of a larger organization)
Parent Organization: LAKE HOSPITAL SYSTEM, INC.
Primary Specialty: Internal Medicine
Enumeration Date: Jun 15, 2006
Last Updated: Sep 6, 2007

Practice Location

Address: 36100 EUCLID AVE
Address 2: #240
City: Willoughby
State: Ohio
ZIP Code: 44094
Phone: (440) 918-4679

Authorized Official

Name: MR. ROBERT TRACZ
Title: CHIEF FINANCIAL OFFICER
Phone: (440) 354-1051

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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