Lake Shore Specialty Group

LBN: Shands At Lake Shore Inc
Lake Shore Specialty Group is an health care organization with primary practice located at 368 Ne Franklin St , Lake City FL 32055-3088. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Shands At Lake Shore Inc can be contacted via phone (386) 754-8000, or through Mansfield, Jodi via phone (352) 265-0440.

Contact Information

Primary practice address
368 Ne Franklin St Lake City FL 32055-3088
Phone: (386) 754-8000
Fax: (352) 733-0069
Website:
Map and Directions
Authorized official contact:
Name: Mansfield, Jodi
Phone: (352) 265-0440

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X 4258 Florida

Profile Details

NPI number 1730275538
LBN Legal business name Shands At Lake Shore Inc
DBA Doing business as Lake Shore Specialty Group
Authorized official Mansfield, Jodi
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 5th, 2006
Last updated May 7th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730275538 NPPES
Florida Other CK8077 MEDICARE RR
Florida MEDICAID 264258100 MEDICARE RR

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