NPIMap

Organization Active NPI

Lewis County Primary Care Center, Inc.

Doing business as Tollesboro Clinic Pharmacy

  • Community/Retail Pharmacy
  • Tollesboro, KY
National Provider Identifier
1477564987
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P06782 Issued in KY
Legal business name
LEWIS COUNTY PRIMARY CARE CENTER, INC.
Doing business as
Tollesboro Clinic Pharmacy
Practice address
17521 W Ky Hwy 9
Tollesboro, KY 41189
Phone
(606) 798-2072
Fax
(606) 798-4276
NPI assigned
Aug 10, 2006
Last updated
Apr 4, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chad Evans, PHARMD
Title
Director of Pharmacy
Phone
(606) 956-0188

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X P06782 KY Primary

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 names 1

  • Tollesboro Clinic Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ashland Location18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1477564987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "TOLLESBORO",
            "state": "KY",
            "postal_code": "411890220",
            "telephone_number": "606-798-2072",
            "fax_number": "606-798-4276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17521 W KY HWY 9",
            "city": "TOLLESBORO",
            "state": "KY",
            "postal_code": "41189",
            "telephone_number": "606-798-2072",
            "fax_number": "606-798-4276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS COUNTY PRIMARY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "606-956-0188",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P06782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tollesboro Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tollesboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.