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CH0510280 LAKE SUPERIOR COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
LAKE SUPERIOR COMMUNITY HEALTH CENTER
Subdivision Name
LAKE SUPERIOR HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-002602
340B ID
CH0510280
Grant Number
H80CS00811
Additional Details
Current Program Status
Active
Registration Date
10/1/2000
Participating Start Date
10/1/2000
Participating Approval Date
3/18/2004
Last Recertification Date
2/21/2025
Contacts
Authorizing Official
LSCHC
Lee Homan, CEO
(218) 336-3503
Primary Contact
Lake Superior Community Health Cent
Lindsey Rae Morgan, Risk and Compliance Manager
(715) 947-2155
Addresses
Street Address
4325 Grand Ave
Duluth, MN 55807-2730
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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CORRECTED ID # - WAS CH051028; 8/11/06 - UPDATED ADDRESS (PREVIOUS ADDRESS: 2 EAST 5TH STREET, DULUTH MN 55805)
08/11/2006
April 2025
April 2025
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