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CHC08752-02 LAKELAND IMMEDIATE CARE CENTER (Active)
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Main Details
Name
LAKELAND IMMEDIATE CARE CENTER
Subdivision Name
Niles Community Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-029683
340B ID
CHC08752-02
Grant Number
H80CS08752
Additional Details
Current Program Status
Active
Registration Date
4/4/2014
Participating Start Date
7/1/2014
Participating Approval Date
4/17/2014
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Cassopolis Family Clinic Network
Joseph Gavan, Chief Executive Officer
(269) 445-3874
Primary Contact
Niles Community Health Center Pharmacy
Kevin Klipowicz, Pharmacy Director
(269) 665-8900
Addresses
Street Address
1951 Oak St.
Niles, MI 49120-3738
Billing Address
Lakeland Immediate Care Center
261 M-62
Cassopolis, MI 49031-1034
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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