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CHC24152-03 Lakeshore Community Health Care, Inc (Active)
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Main Details
Name
Lakeshore Community Health Care, Inc
Subdivision Name
LCHC Calumet
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019745
340B ID
CHC24152-03
Grant Number
H80CS24152
Additional Details
Current Program Status
Active
Registration Date
10/4/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/16/2017
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
2719 Calumet Avenue
Suite A
Manitowoc, WI 54220-5546
Billing Address
Lakeshore Community Health Care, Inc.
PO Box 959
Sheboygan, WI 53081
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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