Organization
LINCOLN COUNTY PRIMARY CARE CENTER, INC.
Active
Other names
Southern West Virginia Health System-Man
Organization subpart
No
Provider details
NPI number
Authorized official
LISA LEACH (CEO)
(304) 824-5806
Entity
Organization
Contact information
Practice address
600 E MCDONALD AVE, MAN, WV 25635-1023
(304) 583-8585
(304) 583-0129
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810018665
—
WV
Enumeration date
03/05/2010
Last updated
05/08/2020
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