NPIMap

Organization Active NPI

Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
National Provider Identifier
1053905976
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTHSHORE HEALTH CENTERS, INC.
Practice address
6091 Broadway
Merrillville, IN 46410-2619
Phone
(219) 763-8944
Fax
(219) 764-5395
NPI assigned
Feb 22, 2021
Organization subpart
Yes
Parent organization
NORTHSHORE HEALTH CENTERS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Hall
Title
Ceo
Phone
(219) 763-8112

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Clinic Pharmacy 3336C0002X

Addresses

Primary practice location

6091 Broadway
Merrillville, IN 46410-2619

Mailing address

PO Box 1430
Portage, IN 46368-9230
Phone (219) 763-8112

Other names 1

  • NorthShore Merrillville Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northshore Health CTRS Inc28 organizations share this tax ID, including this one
Part of
Northshore Health CTRS Inc

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1053905976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463689230",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-5380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6091 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464102619",
            "telephone_number": "219-763-8944",
            "fax_number": "219-764-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE HEALTH CENTERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHSHORE HEALTH CENTERS, INC",
        "enumeration_date": "2021-02-22",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "219-763-8112"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NorthShore Merrillville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NorthShore Merrillville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.