| Northshore Health Centers, Inc. | |
|
6091 Broadway Merrillville IN 46410-2619 | |
| (219) 763-8112 | |
| (219) 884-2547 |
| Full Name | Northshore Health Centers, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 6091 Broadway, Merrillville, Indiana |
| Authorized Official Name and Position | David Hall (CEO) |
| Authorized Official Contact | 2197638112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northshore Health Centers, Inc. Po Box 1430 Portage IN 46368-9230 Ph: (219) 763-8112 | Northshore Health Centers, Inc. 6091 Broadway Merrillville IN 46410-2619 Ph: (219) 763-8112 |
| NPI Number | 1477810315 |
|---|---|
| Provider Enumeration Date | 04/17/2012 |
| Last Update Date | 11/12/2020 |
| Certification Date | 11/12/2020 |
| Medicare PECOS PAC ID | 5799671236 |
|---|---|
| Medicare Enrollment ID | O20120601000538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477810315 | NPI | - | NPPES |
| 200331170G | Medicaid | IN | |
| 151880 | Other | IN | MEDICARE PART A PTAN |
| 191360 | Other | IN | MEDICARE PART B PTAN |
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