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NPI Code Detail

MEDICARE: LORAIN COUNTY HEALTH & DENTISTRY

MEDICARE: LORAIN COUNTY HEALTH & DENTISTRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist
2204E00000XOral & Maxillofacial Surgery (D.M.D.)
3207Q00000XFamily Medicine Physician
4207R00000XInternal Medicine Physician
5207V00000XObstetrics & Gynecology Physician
6208000000XPediatrics Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407024870
Entity Type Code : Organization
Provider Name (Legal Business Name) : LORAIN COUNTY HEALTH & DENTISTRY
Provider Business Mailing Address
First Line : 1205 BROADWAY
Second Line :
City : LORAIN
State : OH
Zip : 44052-3409
Country : US
Telephone Number : 440-240-1655
Fax Number : 440-245-1218
Provider Business Practice Location Address
First Line : 1205 BROADWAY
Second Line :
City : LORAIN
State : OH
Zip : 44052-3409
Country : US
Telephone Number : 440-240-1655
Fax Number : 440-245-1218
Authorized Official
Title or Position : CEO
Name : STEPHANIE WIERSMA
Credential :
Telephone Number : 440-233-1059
Provider Enumeration Date : 02/19/2008
Last Update Date : 06/21/2013

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1124111851 — DR. JOYCE A. RAMSUE-THOMPSON O.D.
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Directions to “LORAIN COUNTY HEALTH & DENTISTRY ” Practice Location

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