NPI | 1053905976 |
---|---|
Doing Business As | NORTHSHORE MERRILLVILLE PHARMACY |
Entity Type | Organization |
Authorized Contact | DAVID HALL CEO 219-763-8112 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
Enumeration Date | 2021-02-22 |
Last Update Date | 2022-03-04 |