Organization
NORTHSHORE HEALTH CENTERS, INC
Active
Parent organization
NORTHSHORE HEALTH CENTERS, INC.
Other names
NorthShore DeMotte 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
200 3RD CT SE, DEMOTTE, IN 46310-7400
(219) 763-8112
(219) 764-5333
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-5333
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
333600000X
Pharmacy
—
—
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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