| Northshore Merrillville Pharmacy | |
|
6091 Broadway Merrillville IN 46410-2619 | |
| (219) 763-8944 | |
| (219) 764-5395 |
| Full Name | Northshore Merrillville Pharmacy |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 6091 Broadway, Merrillville, 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 Merrillville Pharmacy Po Box 1430 Portage IN 46368-9230 Ph: (219) 763-8112 | Northshore Merrillville Pharmacy 6091 Broadway Merrillville IN 46410-2619 Ph: (219) 763-8944 |
| NPI Number | 1053905976 |
|---|---|
| Provider Enumeration Date | 02/22/2021 |
| Last Update Date | 03/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053905976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 3336C0002X | Pharmacy - Clinic Pharmacy | (* (Not Available)) | Secondary |
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