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CH0518280 Stacy McKay Health & Education Center (Active)
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Main Details
Name
Stacy McKay Health & Education Center
Subdivision Name
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003152
340B ID
CH0518280
Grant Number
H80CS02458
Additional Details
Current Program Status
Active
Registration Date
1/1/2004
Participating Start Date
1/1/2004
Participating Approval Date
3/3/2005
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
NorthShore Health Centers
David Hall, CEO
(219) 763-8112 Ext: 8002
Primary Contact
NorthShore Health Centers Inc.
Michael Wichlinski, Pharmacy Director
(219) 763-8112 Ext: 2301
Addresses
Street Address
6450 US HWY 6
PORTAGE, IN 46368
Billing Address
NorthShore Health Center
PO Box 1430
Portage, IN 46368
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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ENTITY NAME CHANGE, 3/3/05 - UPDATED EMAIL
01/13/2010
April 2025
April 2025
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