Organization
LEWIS COUNTY PRIMARY CARE CENTER, INC.
Active
Other names
PrimaryPlus
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY UGRIN (CEO)
(606) 796-3029
Entity
Organization
Contact information
Practice address
142 DEPOT STREET, SOUTH SHORE, KY 41175
(606) 796-3029
(606) 796-6221
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31000268
—
KY
Enumeration date
07/20/2011
Last updated
07/20/2011
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