Organization
LEWIS COUNTY PRIMARY CARE CENTER INC.
Active
Other names
PrimaryPlus
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY UGRIN (CEO)
(606) 796-3029
Entity
Organization
Contact information
Practice address
1551 AUGUSTA CHATHAM RD, AUGUSTA, KY 41002-9224
(606) 756-2117
(606) 756-2135
Mailing address
PO BOX 550, VANCEBURG, KY 41179-0550
(606) 796-3029
(606) 796-6221
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
700041
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31000268
—
KY
Enumeration date
10/01/2010
Last updated
10/01/2010
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