Lake Hospital System, Inc.

NPI #1861420804 in Mentor, Ohio

Provider Information

NPI Number: 1861420804
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 29, 2006
Last Updated: Sep 6, 2007

Practice Location

Address: 9485 MENTOR AVE
Address 2: #210
City: Mentor
State: Ohio
ZIP Code: 44060-4597
Phone: (440) 205-5745

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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