Organization
LINCOLN COUNTY PRIMARY CARE CENTER INC
Active
Organization
LINCOLN COUNTY PRIMARY CARE CENTER INC
Active
Parent organization
LINCOLN COUNTY PRIMARY CARE CENTER INC
Other names
Southern West Virginia Health System-Madison Medical
Organization subpart
Yes
Provider details
NPI number
Legal business name
LINCOLN COUNTY PRIMARY CARE CENTER INC
Authorized official
LETITIA ANN WEAVER (CREDENTIALING COORDINATOR)
(304) 824-5806
Entity
Organization
Contact information
Practice address
471 MAIN ST, MADISON, WV 25130-1223
(304) 369-5170
(304) 306-7982
Mailing address
7400 LYNN AVE, HAMLIN, WV 25523-1138
(304) 824-5806
(304) 824-5804
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720586472
—
WV
Enumeration date
01/29/2018
Last updated
03/08/2023
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