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CH051828C NORTHSHORE HEALTH CENTERS, INC (Active)
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Main Details
Name
NORTHSHORE HEALTH CENTERS, INC
Subdivision Name
NorthShore Dr. Fernando Rivera Dental Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000916
340B ID
CH051828C
Grant Number
H80CS02458
Additional Details
Current Program Status
Active
Registration Date
9/1/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/18/2009
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
3099 Central Ave
Lake Station, IN 46405-2207
Billing Address
NORTH SHORE HEALTH CENTERS
P.O. BOX 1430
PORTAGE, IN 46368
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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