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CH051828R NORTHSHORE HEALTH CENTERS, INC (Active)
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Main Details
Name
NORTHSHORE HEALTH CENTERS, INC
Subdivision Name
NorthShore LaPorte High School Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032742
340B ID
CH051828R
Grant Number
H80CS02458
Additional Details
Current Program Status
Active
Registration Date
10/20/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/21/2021
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
602 F Street RM G.15
LaPorte, IN 46350-5526
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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