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CH051028A LAKE SUPERIOR COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
LAKE SUPERIOR COMMUNITY HEALTH CENTER
Subdivision Name
LSCHC SUPERIOR CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-033535
340B ID
CH051028A
Grant Number
H80CS00811
Additional Details
Current Program Status
Active
Registration Date
4/1/2004
Participating Start Date
4/1/2004
Participating Approval Date
3/11/2004
Last Recertification Date
2/21/2025
Contacts
Authorizing Official
LSCHC
Lee Homan, CEO
(218) 336-3503
Primary Contact
Lake Superior Community Health Cent
Lindsey Rae Morgan, Risk and Compliance Manager
(715) 947-2155
Addresses
Street Address
2222 E 5th St Bldg
Superior, WI 54880
Billing Address
LAKE SUPERIOR COMMUNITY HEALTH CENTER
4325 GRAND AVENUE
DULUTH, MN 55807
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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NEW SITE 04/01/2004; 8/11/06-UPDATED ADDRESS (PREVIOUS ADDRESS: 1419 HILL AVENUE SUITE B, SUPERIOR WI 54880)
08/11/2006
April 2025
April 2025
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