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NPI Code Detail

MEDICARE: LAKESHORE MEDICAL CENTER

MEDICARE: LAKESHORE MEDICAL CENTER
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
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1699814897
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKESHORE MEDICAL CENTER
Provider Business Mailing Address
First Line : 905 E COLBY ST
Second Line :
City : WHITEHALL
State : MI
Zip : 49461-1262
Country : US
Telephone Number : 231-728-5910
Fax Number : 231-728-5918
Provider Business Practice Location Address
First Line : 905 E COLBY ST
Second Line :
City : WHITEHALL
State : MI
Zip : 49461-1262
Country : US
Telephone Number : 231-728-5910
Fax Number : 231-728-5918
Authorized Official
Title or Position : OPERATIONS MANAGER
Name : MRS. COLLEEN BETH JOHNSON
Credential : C.M.P.E.
Telephone Number : 231-728-5910
Provider Enumeration Date : 02/05/2007
Last Update Date : 08/22/2020

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Directions to “LAKESHORE MEDICAL CENTER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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