Lorain County Health & Dentistry

NPI #1720485659 in Elyria, Ohio

Provider Information

NPI Number: 1720485659
Entity Type: Organization
Organization Name: Lorain County Health & Dentistry
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Nov 20, 2014
Last Updated: Nov 20, 2014

Practice Location

Address: 105 LOUDEN CT
City: Elyria
State: Ohio
ZIP Code: 44035-8028
Phone: (440) 240-1655

Authorized Official

Name: STEPHANIE WIERSMA
Title: CEO
Phone: (440) 233-0159

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Family Medicine - Adult Medicine — Adult Medicine	207QA0505X
Internal Medicine	207R00000X
Obstetrics & Gynecology	207V00000X
Pediatrics	208000000X
Nurse Practitioner	363L00000X
Nurse Practitioner - Pediatrics — Pediatrics	363LP0200X
Nurse Practitioner - Primary Care — Primary Care	363LP2300X
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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