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Northshore Health Centers, Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Gary, IN

NPI 1811711864 · NPPES record last updated Nov 14, 2024

Key facts

NPI
1811711864
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
NORTHSHORE HEALTH CENTERS, INC
Practice address
2200 Grant St
Gary, IN 46404-3439
Phone
(219) 706-3534
NPI assigned
Nov 14, 2024
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 27

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

View all 27

National Provider Directory

Tax ID family
Northshore Health CTRS Inc (28 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

2200 Grant St
Gary, IN 46404-3439

Mailing address

2200 Grant St
Gary, IN 46404-3439
Phone (219) 706-3534

Other names

  • NorthShore Gary Pharmacy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 14, 2024.

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1811711864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 GRANT ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464043439",
            "telephone_number": "219-706-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 GRANT ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464043439",
            "telephone_number": "219-706-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE HEALTH CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NorthShore Gary Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gary, IN

All providers in Gary, IN · Federally Qualified Health Center (FQHC) in Indiana

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