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NPI Code Detail

MEDICARE: LCP ENTERPRISES LLC

MEDICARE: LCP ENTERPRISES LLC
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
12083P0901XPublic Health & General Preventive Medicine Physician

General Provider Information

NPI Number : 1730576893
Entity Type Code : Organization
Provider Name (Legal Business Name) : LCP ENTERPRISES LLC
Provider Business Mailing Address
First Line : 5133 DARROW RD
Second Line :
City : HUDSON
State : OH
Zip : 44236-4003
Country : US
Telephone Number : 330-655-2377
Fax Number : 330-342-9802
Provider Business Practice Location Address
First Line : 5133 DARROW RD
Second Line :
City : HUDSON
State : OH
Zip : 44236-4003
Country : US
Telephone Number : 330-655-2377
Fax Number : 330-342-9802
Authorized Official
Title or Position : CEO
Name : MR. JERRY J LYNCH JR.
Credential : CEO
Telephone Number : 330-655-2377
Provider Enumeration Date : 04/16/2015
Last Update Date : 04/16/2015

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Directions to “LCP ENTERPRISES LLC ” Practice Location

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