LAKESHORE COMMUNITY HEALTH CARE, INC; NPI #1508391020

Contact Information

LAKESHORE COMMUNITY HEALTH CARE, INC

2719 CALUMET AVE
MANITOWOC, WI 54220-5546

Phone: 920-686-2333
Fax: 920-686-2334
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for LAKESHORE COMMUNITY HEALTH CARE, INC

NPI #	`1508391020`
LBN Legal business name	LAKESHORE COMMUNITY HEALTH CARE, INC
Authorized official	DAVID HUGHES - (CFO)
Entity	Organization
Organization subpart ¹	No
Enumeration date	04/21/2017
Last updated	04/21/2017 - About 9 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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