Organization
NORTHSHORE HEALTH CENTERS, INC.
Active
Parent organization
NORTHSHORE HEALTH CENTERS, INC
Other names
NorthShore Merrillville Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHSHORE HEALTH CENTERS, INC
Authorized official
DAVID HALL (CEO)
(219) 763-8112
Entity
Organization
Contact information
Practice address
6091 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 763-8944
(219) 764-5395
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-5380
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Enumeration date
02/22/2021
Last updated
03/04/2022
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