LAKESHORE COMMUNITY HEALTH CARE, INC


Address: 2719 Calumet Ave, Manitowoc, WI 54220-5546
Phone: 9206862333

LAKESHORE COMMUNITY HEALTH CARE, INC (NPI# 1508391020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508391020
Entity Type Organization
Organization Name LAKESHORE COMMUNITY HEALTH CARE, INC
Practice Address 2719 Calumet Ave
Manitowoc
WI 54220-5546
Mailing Address Po Box 959
Sheboygan
WI 53082-0959
Practice Telephone 9206862333
Practice Fax Number 9206862334
Mailing Telephone 9207836633
Mailing Fax Number 9207836392
Enumeration Date 2017-04-21
Last Update Date 2017-04-21
Authorized Official Name DAVID HUGHES (CFO)
Authorized Official Telephone 9207836633
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1245520519 Lakeshore Community Health Care, Inc Clinic/Center 510 S. 8th Street, Sheboygan, WI 53081-4404 2011-04-07
1144698549 Lakeshore Community Health Care, Inc Clinic/Center 1721 Saemann Avenue, Sheboygan, WI 53081-2341 2015-09-02
1578990578 Lakeshore Community Health Care, Inc Clinic/Center 1931 N 8th St, Sheboygan, WI 53081-2740 2013-10-04

Office Location

Street Address 2719 CALUMET AVE
City MANITOWOC
State WI
Zip Code 54220-5546

Providers in the same location

NPI Name Taxonomy Address Enumeration
1407917883 Milton Leganchuk Specialist/Technologist 2719 Calumet Ave, Manitowoc, WI 54220-5546 2006-12-12
1770195810 Patrick Thomas Berg Dentist 2719 Calumet Ave, Manitowoc, WI 54220-5546 2020-08-19
1083271209 Joshua Ross Adametz Dentist 2719 Calumet Ave, Manitowoc, WI 54220-5546 2019-05-22
1225531353 Rebecca A Rice Counselor 2719 Calumet Ave, Manitowoc, WI 54220-5546 2018-03-15

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235614843 Katherine Borchardt Registered Nurse 3520 Foxfire Ct, Manitowoc, WI 54220 2018-09-28
1285128215 Aurora Pharmacy Inc Pharmacy 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 2018-06-22
1477937274 Baycare Clinic LLP Psychiatry & Neurology 4801 Expo Drive, Manitowoc, WI 54220 2015-07-13
1831593821 Brittany Camille Schultz Acupuncturist 2510 Washington Street, Manitowoc, WI 54220 2014-10-20
1710311261 Brian E Weitz Physical Therapy Assistant 960 S. Rapids Rd., Manitowoc, WI 54220 2013-09-01
1134499080 Total Renal Care Inc Clinic/Center 3303 Dewey St, Manitowoc, WI 54220 2012-01-10
1679858534 Lisa M Noworatzky Marriage & Family Therapist 926 S. 8th St., Manitowoc, WI 54220 2011-10-11
1306177225 Cynthia Fay Wenzel Licensed Practical Nurse 915 East Linden Avenue, Manitowoc, WI 54220 2010-01-15
1851550628 Roundys Supermarkets Inc Pharmacy 3300 Calumet Ave, Manitowoc, WI 54220 2008-06-05
1851566079 Jennifer C Mcwilliams Registered Nurse 1004 Nth 8th St., Manitowoc, WI 54220 2008-04-29
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245502673 Lakeshore Community Health Care, Inc. Clinic/Center 601 Buffalo St, Manitowoc, WI 54220-6817 2012-02-01

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1326693847 Scenic Bluffs Health Center, Inc Clinic/Center 100 Blackhawk Dr, Viroqua, WI 54665-1315 2019-08-02
1942718762 Sixteenth Street Community Health Centers, Inc. Clinic/Center 2607 S 5th St, Milwaukee, WI 53207-1418 2018-01-15
1659884716 The Lakes Community Health Center, Inc Clinic/Center 15954 Rivers Edge Dr Ste 304, Hayward, WI 54843-7800 2017-11-13
1275056632 Outreach Community Health Centers, Inc. Clinic/Center 9120 W Hampton Ave Ste 119, Milwaukee, WI 53225-4960 2017-07-18
1437695038 Scenic Bluffs Health Center, Inc. Clinic/Center 200 West North Street, Norwalk, WI 54648 2017-01-06
1841742673 The Lakes Community Health Center, Inc Clinic/Center 300 Main Street West, Ashland, WI 54806-3696 2016-10-27
1174071658 Kenosha Community Health Center, Inc. Clinic/Center 2310 Center St, Racine, WI 53403-3330 2016-09-14
1841652021 Scenic Bluffs Health Center, Inc. Clinic/Center 201 E Franklin St Rm B3, Sparta, WI 54656-1803 2016-03-25
1366844003 Scenic Bluffs Health Center, Inc Clinic/Center 201 E Franklin St # B3, Sparta, WI 54656-1803 2014-09-25
1679983423 The Lakes Community Health Center, Inc Clinic/Center 524 Bissell Street, White Lake, WI 54491 2014-05-02
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Competitor

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City MANITOWOC
Zip Code 54220

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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