Healthcare Provider Details

I. General information

NPI: 1932246923
Provider Name (Legal Business Name): LAKE VIEW MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 11TH AVE
TWO HARBORS MN
55616-1300
US

IV. Provider business mailing address

325 11TH AVE
TWO HARBORS MN
55616-1300
US

V. Phone/Fax

Practice location:
  • Phone: 218-834-7300
  • Fax: 218-834-7388
Mailing address:
  • Phone: 218-834-7300
  • Fax: 218-834-7388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI PECK
Title or Position: SVP- CHIEF FINANCIAL OFFICER
Credential:
Phone: 715-847-2575