Lake Hospital System INC

NPI #1922390012 in Madison, Ohio

Provider Information

NPI Number: 1922390012
Entity Type: Organization
Organization Name: Lake Hospital System INC
Primary Specialty: Clinic/Center
Enumeration Date: May 6, 2011
Last Updated: Sep 26, 2011

Practice Location

Address: 6067 N RIDGE RD
City: Madison
State: Ohio
ZIP Code: 44057-2441
Phone: (440) 417-0002

Authorized Official

Name: MR. MICHAEL KITTOE
Title: CFO
Phone: (440) 354-1985

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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