Provider Demographics
NPI:1730576893
Name:LCP ENTERPRISES LLC
Entity type:Organization
Organization Name:LCP ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:JR
Authorized Official - Credentials:CEO
Authorized Official - Phone:330-655-2377
Mailing Address - Street 1:5133 DARROW RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4003
Mailing Address - Country:US
Mailing Address - Phone:330-655-2377
Mailing Address - Fax:330-342-9802
Practice Address - Street 1:5133 DARROW RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4003
Practice Address - Country:US
Practice Address - Phone:330-655-2377
Practice Address - Fax:330-342-9802
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LCP ENTERPRISES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty