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Contact Information

GREAT LAKES AMBULATORY SURGERY CENTER
9002 MENTOR AVE STE B
MENTOR, OH44060-6302
 Phone: 440-283-0244
 Fax: 440-283-0247
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ambulatory Surgical

261QA1903X 49 Ambulatory Surgical Center
Indicates primary specialty

NPI Profile & details for GREAT LAKES AMBULATORY SURGERY CENTER

NPI # 1023498219
LBN Legal business name GREAT LAKES AMBULATORY SURGERY CENTER
Authorized official EMAD MIKHAIL - (OWNER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 06/03/2015
Last updated 01/13/2026 - About 5 months ago
Identifiers
OH License # 35-075570
OH Medicaid 2124534
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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