| Lake Hospital System, Inc. | |
|
7580 Auburn Road Suite 202 Concord Township OH 44077 | |
| (440) 352-0400 | |
| (440) 352-4535 |
| Full Name | Lake Hospital System, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 7580 Auburn Road, Concord Township, Ohio |
| Authorized Official Name and Position | Robert B Tracz (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4403541642 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Hospital System, Inc. Po Box 714328 Columbus OH 43271-4328 Ph: (440) 354-1899 | Lake Hospital System, Inc. 7580 Auburn Road Suite 202 Concord Township OH 44077 Ph: (440) 352-0400 |
| NPI Number | 1316198724 |
|---|---|
| Provider Enumeration Date | 10/03/2008 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316198724 | NPI | - | NPPES |
| LA9368241 | Other | OH | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Vein Clinics Of Lake County Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7965 Auburn Rd, Concord Township, OH 44077 Phone: 440-352-2702 Fax: 440-252-2700 |