| Northshore Health Centers, Inc. | |
|
504 Legacy Plz W La Porte IN 46350-5254 | |
| (219) 763-8112 | |
| (219) 764-5333 |
| Full Name | Northshore Health Centers, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 504 Legacy Plz W, La Porte, Indiana |
| Authorized Official Name and Position | David Hall (CEO) |
| Authorized Official Contact | 2197638112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northshore Health Centers, Inc. Po Box 1430 Portage IN 46368-9230 Ph: (219) 763-8112 | Northshore Health Centers, Inc. 504 Legacy Plz W La Porte IN 46350-5254 Ph: (219) 763-8112 |
| NPI Number | 1154097426 |
|---|---|
| Provider Enumeration Date | 08/18/2021 |
| Last Update Date | 08/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154097426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 333600000X | Pharmacy | (* (Not Available)) | Secondary |
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