Provider Demographics
NPI:1386696458
Name:ENDOSCOPY CENTER OF LAKE COUNTY, LLC
Entity type:Organization
Organization Name:ENDOSCOPY CENTER OF LAKE COUNTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEHRMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-760-9420
Mailing Address - Street 1:9614 OLD JOHNNYCAKE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6521
Mailing Address - Country:US
Mailing Address - Phone:440-205-1225
Mailing Address - Fax:440-205-1278
Practice Address - Street 1:9614 OLD JOHNNYCAKE RIDGE RD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6521
Practice Address - Country:US
Practice Address - Phone:440-205-1225
Practice Address - Fax:440-205-1278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical