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Lincoln County Primary Care Center Inc

Organization Active NPI Community/Retail Pharmacy · Gilbert, WV

NPI 1467925487 · NPPES record last updated Mar 11, 2025

Key facts

NPI
1467925487
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
LINCOLN COUNTY PRIMARY CARE CENTER INC
Practice address
621 Larry Joe Harless Dr
Gilbert, WV 25621
Phone
(304) 664-1147
Fax
(304) 664-1199
NPI assigned
Jan 3, 2019
Organization subpart
No

Authorized official

Name
Letitia Ann Weaver
Title
Credentialing Coordinator
Phone
(304) 824-5806

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 21

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

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WV

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200423002660 WV Part B Supplier - Mass Immunization (Roster Biller Only) 6204821879 Practice locations: Gilbert, WV

National Provider Directory

Tax ID family
Man Rexcellence Program (22 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

621 Larry Joe Harless Dr
Gilbert, WV 25621

Mailing address

7400 Lynn Ave
Hamlin, WV 25523-1138
Phone (304) 824-5806

Other names

  • HARLESS CENTER PHARMACY Doing business as

Other providers in Gilbert, WV

All providers in Gilbert, WV · Community/Retail Pharmacy in West Virginia

Sources for this page

Verify at the official NPI Registry.