| NPI | 1265297618 |
|---|---|
| Doing Business As | NORTHSHORE CROWN POINT PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RHONA GILLIAM Contracting Specialist 219-763-8112 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |