| Lakeshore Community Health Care, Inc. | |
|
601 Buffalo St Manitowoc WI 54220-6817 | |
| (920) 686-2333 | |
| (920) 783-6392 |
| Full Name | Lakeshore Community Health Care, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 601 Buffalo St, Manitowoc, Wisconsin |
| Authorized Official Name and Position | Michele M Schmitt (PROGRAM DIRECTOR) |
| Authorized Official Contact | 9206862333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeshore Community Health Care, Inc. Po Box 959 Sheboygan WI 53082-0959 Ph: (920) 783-6633 | Lakeshore Community Health Care, Inc. 601 Buffalo St Manitowoc WI 54220-6817 Ph: (920) 686-2333 |
| NPI Number | 1245502673 |
|---|---|
| Provider Enumeration Date | 02/01/2012 |
| Last Update Date | 10/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245502673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Mark L Herring M.d., S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1355 Johnston Dr, Manitowoc, WI 54220 Phone: 920-682-2747 Fax: 920-686-1498 | |
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