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General NPI Number Information
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NPI Number | 1811988983
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Entity Type | Organization
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Legal Business Name | LAKEWOOD HEALTH SYSTEM
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 653 PILLSBURY STREET NORTH SUITE 1
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City | PILLAGER
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State | MN
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Zip | 56473
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Country | US
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Telephone | 218-746-4550
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Fax | 218-898-7595
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Provider Business Mailing Address
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Address Line | 49725 COUNTY 83
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City | STAPLES
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State | MN
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Zip | 56479-5280
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Country | US
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Telephone | 218-894-1515
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Fax | 218-898-7596
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Authorized Official
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Title or Position | CFO
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Name | JOSEPH T REYCRAFT
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Credential |
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Telephone | 218-894-8194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | MN
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