Organization
NORTHSHORE HEALTH CENTERS, INC.
Active
Parent organization
NORTHSHORE HEALTH CENTERS, INC.
Other names
NorthShore Crown Point Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHSHORE HEALTH CENTERS, INC.
Authorized official
RHONA GILLIAM (CONTRACTING SPECIALIST)
(219) 763-8112
Entity
Organization
Contact information
Practice address
310 W 112TH AVE, CROWN POINT, IN 46307
(219) 763-8113
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
02/15/2024
Last updated
02/15/2024
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