Organization

Lake Hospital System Inc.

May also be knows as Lake Health Urgent Care And Walk In Center

Urgent Care Clinic/Center in Willowick, OH(View on Map)

Legal Business Name

Lake Hospital System Inc.

Also Known As

Lake Health Urgent Care And Walk In Center

NPI Number

1912967209

NPI Type

Organization

Enumeration Date

03/23/2006

Specialties

(Taxonomies)

Code

261QU0200X
207Q00000X
208D00000X
207R00000X

Primary Taxonomy

Yes
No
No
No

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 781348
29804 LAKE SHORE BLVD

City

Detroit
Willowick

State

MI
OH

Postal Code

48278-1348
44095-4611

Country

US
US

Telephone Number

(800) 354-1895
(440) 585-3322

Authorized Official

Name

Mr. Bob Tracz

Title or Position

CFO

Telephone Number

(440) 354-1953

Identifiers

Identifier

264200001
80507
2017301
264200001
6600162
2440148

Identifier State

OH
OH
OH
OH
OH
OH

Identifier Issuer

DEPT OF LABOR
QUALCHOICE
Unknown
FEDERAL BLACK LUNG
UNITED HEALTHCARE
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/15/2017

Provider Address