LAKESHORE AREA RADIATION ONCOLOGY CENTER (NPI# 1295820900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295820900 |
| Entity Type | Organization |
| Organization Name | LAKESHORE AREA RADIATION ONCOLOGY CENTER |
| Practice Address |
12642 Riley St Holland MI 49424-9202 |
| Practice Telephone | 6163553876 |
| Practice Fax Number | 6167860255 |
| Mailing Telephone | 6163553876 |
| Mailing Fax Number | 6167860255 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2015-06-15 |
| Authorized Official Name | MR. RYAN POWERS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6167727513 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0203X |
Clinic/Center Specialization: Oncology, Radiation |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 32-0-G0-1091-0 | 01 |
| MI | PRIORITY HEALTH | 002827 | 01 |
| Street Address |
12642 RILEY ST |
| City | HOLLAND |
| State | MI |
| Zip Code | 49424-9202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290999 | Anderson Family and Cosmetic Dentistry | Dentist | 453 136th Ave., Holland, MI 49424 | 2018-10-08 |
| 1487139663 | Maria C. Hoekstra Dds, P.C. | Dentist | 1121 Ottawa Beach Road, Suite 100, Holland, MI 49424 | 2018-10-03 |
| 1871024000 | Derek Schaaf | Rehabilitation Practitioner | 13835 Foxtrail Dr., Holland, MI 49424 | 2017-03-21 |
| 1699227397 | Tabitha Margritz | Optometrist | 2279 N Park Drive #910, Holland, MI 49424 | 2016-10-28 |
| 1619373701 | Miller Chiropractic LLC | Chiropractor | 84 East Lakewood Boulevard, Holland, MI 49424 | 2014-11-17 |
| 1891107611 | Nathan B. Poel | Dentist | 1180 Ottawa Beach Rd, Suite E, Holland, MI 49424 | 2014-05-28 |
| 1477990802 | Jeanine Hamilton | Speech-Language Pathologist | 1576 Eb Creek Dr., Holland, MI 49424 | 2013-05-24 |
| 1194062638 | Stefan John Kuipers | Physician Assistant | 3100 Wellness Dr, Holland, MI 49424 | 2013-01-03 |
| 1902155690 | Benjamin Eovaldi | General Practice | 376 Mayfair St., Holland, MI 49424 | 2012-09-10 |
| 1295017929 | Employee Assistance Center Garden | Psychologist | 372 Garden, Holland, MI 49424 | 2011-09-20 |
| Find all providers in zip 49424 | ||||
| Taxonomy Code | 261QX0203X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology, Radiation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942667647 | Eli Sapir | Clinic/Center | 1500 E. Medical Center Drive (uh B2 C490), University of Michigan, Dept. of Radiaiton Oncology, Ann Arbor, MI 48109-5010 | 2016-01-26 |
| 1922482868 | American Academy of Nurse Practitioners | Clinic/Center | 8050 Fairview Ct, Jackson, MI 49201-9242 | 2015-07-09 |
| 1295972875 | Mclaren Owosso Cancer Center | Clinic/Center | 826 W King St, Owosso, MI 48867-2120 | 2009-01-19 |
| 1639368293 | Johnson Family Center for Cancer Care | Clinic/Center | 1440 E Sherman Blvd, Muskegon, MI 49444-1878 | 2007-10-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.