Lewis County Primary Care Center, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · South Shore, KY
NPI 1891083036 · NPPES record last updated Jul 20, 2011
Key facts
- NPI
- 1891083036
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- LEWIS COUNTY PRIMARY CARE CENTER, INC.
- Practice address
- 142 Depot Street
South Shore, KY 41175 - Phone
- (606) 796-3029
- Fax
- (606) 796-6221
- NPI assigned
- Jul 20, 2011
- Organization subpart
- No
Authorized official
- Name
- Jerry Ugrin
- Title
- Ceo
- Phone
- (606) 796-3029
Corporate family (same tax ID) 17
National Provider Directory
- Tax ID family
- Ashland Location
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
142 Depot Street
South Shore, KY 41175
Mailing address
PO Box 550
Vanceburg, KY 41179-0550
Phone (606) 796-3029
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31000268 | Medicaid | KY |
Other names
- PrimaryPlus
Other providers in South Shore, KY
- Matthew G Hudson
- Samuel David Hudson
- Jerry Wayne Iery
- Joseph Dental of South Shore LLC
- Lewis County Primary Care Center, Inc.
- Little Leaps Therapy Co.
- McDonald Pharmacy Inc
- Sarah Martin Meadows
- Forrest Elmer Monoskie
- Karen Sue Morrow I
All providers in South Shore, KY · Federally Qualified Health Center (FQHC) in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2011. 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.