Organization · Type 2 NPI

Northshore Health Centers, Inc.

Federally Qualified Health Center (FQHC) · Lake Station, IN

NPI number 1972895647 Active

Practice location

3304 Parkside Ave
Lake Station, IN 46405-1143

Call (219) 763-8112 Map

Fax (219) 962-1860

Mailing address

PO Box 1430
Portage, IN 46368-9230

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed
Nurse Practitioner	363L00000X	None listed
Family Nurse Practitioner	363LF0000X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Kari Payton, LAT, ATCAthletic Trainer Lake Station, IN NPI 1215289186

Other federally qualified health center (fqhc) providers in Lake Station

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NPI record

NPI: 1972895647
Entity type: Organization (Type 2)
Issued: May 12, 2011
Last updated: Sep 22, 2020
Status: Active

Other names

<unavail>
Northshore Edison Senior High School · doing business as
Northshore Edison Senior High School · doing business as

Authorized official

David Hall
CEO
(219) 763-8112

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1972895647

Northshore Health Centers, Inc.'s National Provider Identifier is 1972895647, issued on May 12, 2011. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Lake Station, IN. The record was last updated on Sep 22, 2020.