Organization
LINCOLN COUNTY PRIMARY CARE CENTER, INC
Active
Other names
Mustang Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
LISA LEACH (CEO)
(304) 824-5806
Entity
Organization
Contact information
Practice address
267 MIDWAY RD, ALUM CREEK, WV 25003-9591
(304) 756-1007
(304) 756-1010
Mailing address
7400 LYNN AVE, HAMLIN, WV 25523-1138
(304) 824-5806
(304) 824-5885
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
2317-5033
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003274580
—
WV
Enumeration date
01/29/2016
Last updated
10/02/2018
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