Lewis County Primary Care Center, Inc.
Organization Active NPI Community/Retail Pharmacy · Tollesboro, KY
NPI 1477564987 · NPPES record last updated Apr 4, 2017
Key facts
- NPI
- 1477564987
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- P06782 (KY)
- Legal business name
- LEWIS COUNTY PRIMARY CARE CENTER, INC.
- Practice address
- 17521 W Ky Hwy 9
Tollesboro, KY 41189 - Phone
- (606) 798-2072
- Fax
- (606) 798-4276
- NPI assigned
- Aug 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Chad Evans, PHARMD
- Title
- Director of Pharmacy
- Phone
- (606) 956-0188
Corporate family (same tax ID) 17
National Provider Directory
- Tax ID family
- Ashland Location
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | P06782 | KY | Yes |
Addresses
Primary practice location
17521 W Ky Hwy 9
Tollesboro, KY 41189
Mailing address
PO Box 220
Tollesboro, KY 41189-0220
Phone (606) 798-2072
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54003603 | Medicaid | KY | |
| 2034000 | Other | PK |
Other names
- Tollesboro Clinic Pharmacy
Other providers in Tollesboro, KY
- Taylor Douglas
- Michelle Lee Gilliland
- Erin M Himes
- Lewis County Health Department
- Lewis County Primary Care Center, Inc.
- Penny Sue Liles
- Trayla Liles I
- Patti S Poczatek
All providers in Tollesboro, KY · Community/Retail Pharmacy in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.