| Northshore Health Centers, Inc. | |
|
6050 Sterling Creek Rd Portage IN 46368-7752 | |
| (219) 763-8112 | |
| (219) 764-5380 |
| Full Name | Northshore Health Centers, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 6050 Sterling Creek Rd, Portage, Indiana |
| Authorized Official Name and Position | David Hall (CEO) |
| Authorized Official Contact | 2197638112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northshore Health Centers, Inc. Po Box 1430 Portage IN 46368-9230 Ph: (219) 763-8112 | Northshore Health Centers, Inc. 6050 Sterling Creek Rd Portage IN 46368-7752 Ph: (219) 763-8112 |
| NPI Number | 1407061336 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 09/22/2020 |
| Certification Date | 09/22/2020 |
| Medicare PECOS PAC ID | 5799671236 |
|---|---|
| Medicare Enrollment ID | O20040603001258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407061336 | NPI | - | NPPES |
| 200331170B | Medicaid | IN | |
| 151834 | Other | IN | MERICARE PART A PTAN |
| 191360 | Other | IN | MEDICARE PART B PTAN |
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