| Northshore Health Centers, Inc. | |
|
9825 Wicker Ave Side Saint John IN 46373-9413 | |
| (219) 763-8112 | |
| (219) 764-5380 |
| Full Name | Northshore Health Centers, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 9825 Wicker Ave Side, Saint John, 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. 9825 Wicker Ave Side Saint John IN 46373-9413 Ph: (219) 763-8112 |
| NPI Number | 1851966089 |
|---|---|
| Provider Enumeration Date | 05/20/2021 |
| Last Update Date | 05/20/2021 |
| Medicare PECOS PAC ID | 5799671236 |
|---|---|
| Medicare Enrollment ID | O20210824001326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851966089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Community Hospital Care Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9660 Wicker Avenue, Saint John, IN 46373 Phone: 219-365-1166 Fax: 219-365-8852 | |
Community Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9660 Wicker Ave, Saint John, IN 46373 Phone: 219-365-1166 Fax: 219-365-8852 | |
St John Family Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10860 Maple Ln, Saint John, IN 46373 Phone: 219-365-7000 Fax: 219-365-2609 |