Lake Shore Clinic is a Clinic/center in , . Lake Shore Clinic practices all healthcare services and medical treatments related to Clinic/center. The NPI Number for Lake Shore Clinic is 1366566424. The last update date is 2018-06-21.
Lake Shore Clinic's current location address is , , . You can contact this provider via phone number . The mailing address for Lake Shore Clinic is , , . To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Shore Clinic |
|---|---|
| Address | , , |
| Phone Number | |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | BUSINESS M |
|---|---|
| Authorized Official Name | Deery A Judith |
| Credentials | RN |
| Telephone Number | 5748423327 |
NPI Number Detail
| NPI Number | 1366566424 |
|---|---|
| Provider Enumeration Date | 2007-03-16 |
| Last Updated Date | 2018-06-21 |
Provider Mailing Address Detail
| Address | |
|---|---|
| City | |
| State | () |
| Post Code | |
| Phone Number | |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinic/center |
|---|---|
| Taxonomy | 261Q00000X |
| Licence No | 207Q000000X |
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Definition: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 15D0356500 | IN | CLIA NUMBER | |
| 207Q000000X | IN | TAXONOMY |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Lake Shore Clinic by the Centers for Medicare & Medicaid Services?
The Lake Shore Clinic has been issued the NPI (National Provider Identifier) 1366566424, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Lake Shore Clinic is physically located?
The Lake Shore Clinic is situated at the following address: , , .
What is Lake Shore Clinic's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Lake Shore Clinic is Clinic/center, and the taxonomy classification code that categorizes this area of expertise is 261Q00000X.
When did Lake Shore Clinic receive its 1366566424 assignment?
The Lake Shore Clinic was assigned its 1366566424 on 2007-03-16, which is the date when this unique identifier was issued to the organization.
As of what date was the information pertaining to Lake Shore Clinic, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Lake Shore Clinic, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2018-06-21.
NPI Number: 1457354839
Address: P.o. Box 1252, Spartanburg, SC