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CHC24152-04 Lakeshore Community Health Care, Inc (Active)
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Main Details
Name
Lakeshore Community Health Care, Inc
Subdivision Name
LCHC @ Longfellow Elementary
Type
HRSA-Funded Health Center
Site ID
BPS-H80-028275
340B ID
CHC24152-04
Grant Number
H80CS24152
Additional Details
Current Program Status
Active
Registration Date
1/4/2021
Participating Start Date
4/1/2021
Participating Approval Date
1/5/2021
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
819 Kentucky Ave Rm 135/139
Sheboygan, WI 53081-4954
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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