Provider Demographics
NPI:1952691388
Name:LAKESHORE HEALTH PARTNERS
Entity Type:Organization
Organization Name:LAKESHORE HEALTH PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LEO
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:I
Authorized Official - Credentials:NHA
Authorized Official - Phone:440-967-6614
Mailing Address - Street 1:983 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-1256
Mailing Address - Country:US
Mailing Address - Phone:440-967-6614
Mailing Address - Fax:440-967-1968
Practice Address - Street 1:350 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6142
Practice Address - Country:US
Practice Address - Phone:440-390-0153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1954085332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies