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Lake Hospital System

Organization Active NPI Registered Dietitian · Willoughby, OH

NPI 1255394136 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1255394136
Entity type
Organization (NPI type 2)
Primary specialty
Registered Dietitian 133V00000X
Legal business name
LAKE HOSPITAL SYSTEM
Practice address
36000 Euclid Ave
Willoughby, OH 44094-4625
Phone
(440) 953-6082
NPI assigned
Apr 11, 2006
Organization subpart
No

Authorized official

Name
Mr. Robert Tracz
Title
Cfo
Phone
(440) 354-1990

Corporate family (same tax ID) 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Lake Medical Center (37 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian
Group: 193400000X SINGLE SPECIALTY GROUP		 133V00000X Yes

Addresses

Primary practice location

36000 Euclid Ave
Willoughby, OH 44094-4625

Mailing address

PO Box 714031
Columbus, OH 43271-4031
Phone (440) 716-1283

Other providers in Willoughby, OH

All providers in Willoughby, OH · Registered Dietitian in Ohio

Sources for this page

Verify at the official NPI Registry.