| Northshore Health Centers, Inc | |
|
1828 165th St Ste A Hammond IN 46320-2823 | |
| (219) 763-8112 | |
| (219) 844-9006 |
| Full Name | Northshore Health Centers, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1828 165th St Ste A, Hammond, 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 1828 165th St Ste A Hammond IN 46320-2823 Ph: (219) 763-8112 |
| NPI Number | 1023440526 |
|---|---|
| Provider Enumeration Date | 08/07/2013 |
| Last Update Date | 02/03/2021 |
| Certification Date | 02/03/2021 |
| Medicare PECOS PAC ID | 5799671236 |
|---|---|
| Medicare Enrollment ID | O20131127000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023440526 | NPI | - | NPPES |
| 191360 | Other | IN | MEDICARE PART B PTAN |
| 200331170H | Medicaid | IN | |
| 151912 | Other | IN | MEDICARE PART A PTAN |
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