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CHC24152-02 LAKESHORE COMMUNITY HEALTH CARE, INC (Active)
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Main Details
Name
LAKESHORE COMMUNITY HEALTH CARE, INC
Subdivision Name
Lakeshore Community Health Care Medical/BH
Type
HRSA-Funded Health Center
Site ID
BPS-H80-016951
340B ID
CHC24152-02
Grant Number
H80CS24152
Additional Details
Current Program Status
Active
Registration Date
7/9/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/10/2015
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Lakeshore Community Health Care
Kristin Blanchard Stearns, CEO
(920) 783-6633 Ext: 204
Primary Contact
Lakeshore Community Health Care
Christa Wilson, Director of Pharmacy
(920) 783-6633 Ext: 255
Addresses
Street Address
1721 Saemann Ave.
Sheboygan, WI 53081-2342
Billing Address
Lakeshore Community Health Care, Inc.
PO Box 959
Sheboygan, WI 53082-0959
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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