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CH051828K NORTHSHORE HEALTH CENTERS, INC (Active)
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Main Details
Name
NORTHSHORE HEALTH CENTERS, INC
Subdivision Name
NorthShore LaPorte Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032342
340B ID
CH051828K
Grant Number
H80CS02458
Additional Details
Current Program Status
Active
Registration Date
10/7/2020
Participating Start Date
1/1/2021
Participating Approval Date
10/13/2020
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
504 Legacy Plaza W
Laporte, IN 46350-3353
Billing Address
NorthShore Health Centers, Inc.
PO 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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