Lake Wales Hospital Corporation

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

4007 Issued in FL

Legal business name

LAKE WALES HOSPITAL CORPORATION

Doing business as

Lake Wales Medical Center

Practice address

410 S 11TH St
Lake Wales, FL 33853-4203

Phone

(863) 676-1433

NPI assigned

Jan 27, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paula M Lalor

Title

Director/Delegated Official

Phone

(615) 925-4565

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Lake Wales Medical Center Doing business as

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Lake Wales Hospital Corporation

  dba Lake Wales Medical Center

  • Psychiatric Hospital Unit
  • Lake Wales, FL
  • NPI 1841696762
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520553600000",
    "number": "1033180195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403164",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303843164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534203",
            "telephone_number": "863-676-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WALES HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2018-03-09",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "615-925-4565"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "4007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010166400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "501",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AV-MED",
            "identifier": "101662",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Wales Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lake Wales Clinic Corp
• Lake Wales Dental Associates
• Lake Wales Emergency Physicians, LLC
• Lake Wales Foot and Ankle Care, Inc
• Lake Wales Healthcare LLC (Grace Healthcare of Lake Wales)
• Lake Wales Hospital Corporation (Lake Wales Medical Center)
• Lake Wales Medial Center
• Lake Wales Medical Imaging Center One, Inc
• Lake Wales Medical Walk in Clinic PA
• Lake Wales Operating Group LLC

• General Acute Care Hospital in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• General Acute Care Hospital in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.