Covered Entity Details

CH03085A LINCOLN COUNTY PRIMARY CARE CENTER, INC. (Active) - information as of 5/9/2025 10:44:57 PM

Main Details

Name

LINCOLN COUNTY PRIMARY CARE CENTER, INC.

Subdivision Name

Southern West Virginia Health System-Man

Type

HRSA-Funded Health Center

Site ID

BPS-H80-030377

340B ID

CH03085A

Grant Number

H80CS00254

Additional Details

Current Program Status

Active

Registration Date

5/12/2010

Participating Start Date

7/1/2010

Participating Approval Date

5/19/2010

Last Recertification Date

2/18/2025

Contacts

Authorizing Official

Lincoln County Primary Care Center Inc.
Lisa King Leach, CEO
(304) 824-5806 Ext: 1236

Primary Contact

LINCOLN COUNTY PRIMARY CARE CENTER INC
Chris Harper, Director of Pharmacy Services
(304) 824-5806 Ext: 1237

Addresses

Street Address

600 East McDonald Avenue
Man, WV 25635-1012

Billing Address

LINCOLN COUNTY PRIMARY CARE CENTER, INC.
7400 LYNN AVENUE
HAMLIN, WV 25523

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Shipping Address 1

R-EXCELLENCE PROGRAM - MAN
600 E. MCDONALD AVENUE
MAN, WV 25635

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH030850	Active	BPS-H80-004725	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	7400 Lynn Ave	Hamlin	WV
CH03085A	Active	BPS-H80-030377	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Southern West Virginia Health System-Man	600 East McDonald Avenue	Man	WV
CH03085AA	Approved	BPS-H80-039585	LINCOLN COUNTY PRIMARY CARE CENTER INC	Van Junior/Senior High School Health Center	913 Van High School Rd	Van	WV
CH03085AB	Approved	BPS-H80-039609	LINCOLN COUNTY PRIMARY CARE CENTER INC	Van Elementary School Health Center	338 Van High School Rd	Van	WV
CH03085B	Active	BPS-H80-011043	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Southern West Virginia Health System - Delbarton	5027 Helena Avenue	Delbarton	WV
CH03085C	Active	BPS-H80-007697	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Guyan Valley Wellness Center	5322 McClellan Highway	Branchland	WV
CH03085D	Active	BPS-H80-012446	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Southern West Virginia Health System	1563 Sand Plant Rd	Charleston	WV
CH03085E	Active	BPS-H80-004756	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	LCHS Panther Center for Health	81 Lincoln Panther Way	Hamlin	WV
CH03085F	Active	BPS-H80-006406	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Duval Middle School Health Center	5304 Straight Fork Rd.	Griffithsville	WV
CH03085G	Active	BPS-H80-009404	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Southern West Virginia Health System-Gilbert	621 Larry Joe Harless Dr.	Gilbert	WV
CH03085H	Active	BPS-H80-010024	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	CRHS Tiger Center for Health	506 CRAWLEY CREEK RD	Chapmanville	WV
CH03085J	Active	BPS-H80-010595	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Salt Rock Medical Center	5490 State Route 10	Salt Rock	WV
CH03085K	Terminated	BPS-H80-007339	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	West Hamlin Elementary School	Route 1, Box 112A	West Hamlin	WV
CH03085L	Active	BPS-H80-010615	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Southern West Virginia Health System-Logan	122 Nick Savas Drive	Logan	WV
CH03085M	Active	BPS-H80-011415	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Logan Wildcat Health Center	1 Wildcat Way	Logan	WV
CH03085N	Active	BPS-H80-017671	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Mustang Health Center	267 MIDWAY RD	ALUM CREEK	WV
CH03085P	Terminated	BPS-H80-017672	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Ranger Health Center	59 VANATTERS CRK	RANGER	WV
CH03085Q	Active	BPS-H80-017975	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Pioneer Health Center	1 Pioneer Path	Man	WV
CH03085R	Active	BPS-H80-021405	LINCOLN COUNTY PRIMARY CARE CENTER, INC.	Southern West Virginia Health System-Madison	471 Main Street	Madison	WV
CH03085S	Active	BPS-H80-036307	LINCOLN COUNTY PRIMARY CARE CENTER INC	Sherman Junior/Senior High Health Center	10008 Coal River Rd	Seth	WV
CH03085T	Active	BPS-H80-036308	LINCOLN COUNTY PRIMARY CARE CENTER INC	Southern West Virginia Health System - Oceana	26 Trinity Ln	Oceana	WV
CH03085U	Active	BPS-H80-036358	LINCOLN COUNTY PRIMARY CARE CENTER INC	Southern West Virginia Health System - Whitesville	37456 Coal River Rd	Whitesville	WV
CH03085V	Active	BPS-H80-036357	LINCOLN COUNTY PRIMARY CARE CENTER INC	Southern West Virginia Health System - Wharton	35767 Pond Fork Rd	Wharton	WV
CH03085W	Active	BPS-H80-036249	LINCOLN COUNTY PRIMARY CARE CENTER INC	Sherman Elementary Health Center	7487 Coal River Rd	Comfort	WV
CH03085X	Active	BPS-H80-033643	LINCOLN COUNTY PRIMARY CARE CENTER INC	Bobcat Health Center	8130 Court Ave	Hamlin	WV
CH03085Y	Active	BPS-H80-033694	LINCOLN COUNTY PRIMARY CARE CENTER INC	Lincoln Education Wellness Center	10 Marland Ave	Hamlin	WV
CH03085Z	Approved	BPS-H80-039679	LINCOLN COUNTY PRIMARY CARE CENTER INC	Southern West Virginia Health System - Chapmanville	40 Shae Ave	Chapmanville	WV

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH030850	ARACOMA DRUG CO OF CHAPMANVILLE	772 MAIN ST		CHAPMANVILLE	WV	25508-4533	07/01/2025
CH030850	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	10/01/2023
CH030850	DANVILLE PHARMACY	2008 SMOOT AVENUE		DANVILLE	WV	25053	10/01/2024
CH030850	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	07/01/2024
CH030850	KROGER PHARMACY #668	25 HOLDEN ROAD	P.O. BOX 1264	MOUNT GAY	WV	25637	07/01/2023
CH030850	KROGER PHARMACY #817	3265 SMOOT AVE		DANVILLE	WV	25053	07/01/2023
CH030850	MILLER BROTHERS PHARMACY	271 MAIN ST		MADISON	WV	25130-1219	10/01/2024
CH030850	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	10/01/2024
CH030850	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	10/01/2024
CH030850	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	10/01/2024
CH030850	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	10/01/2024
CH030850	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	10/01/2024
CH030850	VAN PHARMACY, INC	19024 POND FORK ROAD	PO BOX 450	VAN	WV	25206	05/31/2023
CH030850	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2023
CH030850	WAL-MART PHARMACY 10-2036	2700 MOUNTAINEER BLVD		SOUTH CHARLESTON	WV	25309	07/01/2023
CH030850	WAL-MART PHARMACY 10-2548	28402 U.S. HWY 119 NO.		SO WILLIAMSON	KY	41503	07/01/2023
CH030850	WAL-MART PHARMACY 10-2610	77 NORMAN MORGAN BLVD		LOGAN	WV	25601	07/01/2023
CH030850	WAL-MART PHARMACY 10-5296	25 NICHOLS DRIVE		BARBOURSVILLE	WV	25504	07/01/2023
CH030850	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2023
CH030850	WALGREEN CO.	WALGREENS #19746	894 COOK PKWY	OCEANA	WV	24870-0019	06/02/2023
CH030850	WALGREEN CO.	WALGREENS #17559	69 LEWIS ST.	WHITESVILLE	WV	25209	06/02/2023
CH030850	WALGREEN CO.	WALGREENS #17782	8315 COURT AVE	HAMLIN	WV	25523-1332	10/01/2023	11/16/2023
CH030850	WALGREEN CO.	WALGREENS #19954	260 HUFFCREEK HWY	MAN	WV	25635-1039	10/01/2023
CH030850	WALGREEN CO.	WALGREENS #17792	901 MAIN ST	CHAPMANVILLE	WV	25508-4547	10/01/2023
CH030850	WALGREEN CO.	WALGREENS #17413	1662 SMOOT AVE PO BOX 286	DANVILLE	WV	25053-0286	10/01/2023
CH030850	WALGREEN CO.	WALGREENS #18275	28 MAIN AVE PO BOX 4547	LOGAN	WV	25601-3331	10/01/2023
CH030850	WALGREEN CO.	WALGREENS #17534	5798 MCCLELLAN HWY	BRANCHLAND	WV	25506-8700	10/01/2023
CH030850	WALGREEN CO.	WALGREENS #17504	164 HOLDEN RD	MOUNT GAY	WV	25637	01/01/2025
CH030850	Walgreens #21420	Walgreens Central Fill #21420	8440 Times Dispatch Blvd Ste. 400	Mechanicsville	VA	23116	10/01/2023
CH030850	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	06/02/2023	11/05/2021
CH030850	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	06/02/2023
CH030850	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	06/02/2023
CH030850	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	06/02/2023
CH030850	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023	01/16/2024
CH030850	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	04/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/2/2024 2:27:20 PM	2/18/2025 2:48:19 PM	2/18/2025 2:48 PM
Details	Last Recertification Date	Update	Recertification	1/30/2023 1:53:27 PM	2/2/2024 2:27:20 PM	2/2/2024 2:27 PM
Details	Last Recertification Date	Update	Recertification	2/1/2022 3:00:58 PM	1/30/2023 1:53:27 PM	1/30/2023 1:53 PM
Addresses	Shipping Address	Delete	Recertification	R-EXCELLENCE PROGRAM - MAN 650 E. MCDONALD AVENUE MAN, WV 25635		2/1/2022 3:00 PM
Addresses	Shipping Address	Insert	Recertification		R-EXCELLENCE PROGRAM - MAN 600 E. MCDONALD AVENUE MAN, WV 25635	2/1/2022 3:00 PM
Addresses	Main Address	Update	Recertification	650 East McDonald Avenue Man, WV 25635-1012	600 East McDonald Avenue Man, WV 25635-1012	2/1/2022 3:00 PM
Details	Last Recertification Date	Update	Recertification	3/3/2021 1:41:38 PM	2/1/2022 3:00:58 PM	2/1/2022 3:00 PM
Details	Last Recertification Date	Update	Recertification	1/28/2020 11:16:49 AM	3/3/2021 1:41:38 PM	3/3/2021 1:41 PM
Details	Last Recertification Date	Update	Recertification	1/29/2019 4:58:52 PM	1/28/2020 11:16:49 AM	1/28/2020 11:16 AM
Details	Last Recertification Date	Update	Recertification	2/8/2018 9:47:28 AM	1/29/2019 4:58:52 PM	1/29/2019 4:58 PM
Contacts	Authorizing Official	Update	Change Request	Crist, Brian K. CEO Lincoln County Primary Care Center Inc. 3048245806-1236	Leach, Lisa King CEO Lincoln County Primary Care Center Inc. 3048245806-1236	4/17/2018 3:11 PM
Details	Last Recertification Date	Update	Recertification	1/31/2017 12:00:00 AM	2/8/2018 9:47:28 AM	2/8/2018 9:47 AM
Contacts	Authorizing Official	Update		Crist, Brian K. CEO 3048245806-1236	Crist, Brian K. CEO Lincoln County Primary Care Center Inc. 3048245806-1236	1/8/2018 4:06 PM
Contacts	Primary Contact	Update		Harper, Chris Director of Pharmacy Services 3048245806-1237	Harper, Chris Director of Pharmacy Services LINCOLN COUNTY PRIMARY CARE CENTER INC 3048245806-1237	9/29/2017 1:26 PM
Contacts	Authorizing Official	Insert			Crist, Brian K. CEO 3048245806-1236	5/1/2017 5:44 PM
Contacts	Primary Contact	Update		HARPER, CHRISTOPHER PHARMACIST 3048245806-1237	Harper, Chris Director of Pharmacy Services 3048245806-1237	5/1/2017 5:44 PM
Addresses	Main Address	Insert			650 East McDonald Avenue Man, WV 25635-1012	1/31/2017 2:19 PM
Details	Last Recertification Date	Update		2/16/2016 12:00:00 AM	1/31/2017 12:00:00 AM	1/31/2017 2:19 PM
Contacts	Primary Contact	Insert			HARPER, CHRISTOPHER PHARMACIST 3048245806-1237	2/16/2016 10:20 AM
Details	Last Recertification Date	Update		2/3/2015 12:00:00 AM	2/16/2016 12:00:00 AM	2/16/2016 10:20 AM
Addresses	Billing Address	Insert			LINCOLN COUNTY PRIMARY CARE CENTER, INC. 7400 LYNN AVENUE HAMLIN, WV 25523	3/20/2015 1:46 PM
Addresses	Shipping Address	Insert			R-EXCELLENCE PROGRAM - MAN 650 E. MCDONALD AVENUE MAN, WV 25635	3/20/2015 1:46 PM
Details	Last Recertification Date	Update		2/10/2014 12:00:00 AM	2/3/2015 12:00:00 AM	2/3/2015 11:46 AM
Details	Entity Subname	Update		SOUTHERN WEST VIRGINIA HEALTH SYSTEM-MAN	Southern West Virginia Health System-Man	3/31/2014 4:25 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	2/10/2014 12:00:00 AM	2/10/2014 9:31 AM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/15/2013 10:00 AM
Details	Last Recertification Date	Insert				11/18/2010 1:46 PM
Details	Grant Number	Insert			H80CS00254	11/18/2010 1:46 PM
Details	340B ID	Insert			CH03085A	11/18/2010 1:46 PM
Details	Is Authorizing Official EHB Data	Insert				11/18/2010 1:46 PM
Dates	Last Date That 340B Drugs Purchased	Insert				11/18/2010 1:46 PM
Details	Medicare Provider Number	Insert				11/18/2010 1:46 PM
Details	Entity Name	Insert			LINCOLN COUNTY PRIMARY CARE CENTER, INC.	11/18/2010 1:46 PM
Details	Program Code	Insert			CH	11/18/2010 1:46 PM
Details	Entity Subname	Insert			SOUTHERN WEST VIRGINIA HEALTH SYSTEM-MAN	11/18/2010 1:46 PM
Dates	Participating Approval Date	Insert			5/19/2010 12:00:00 AM	11/18/2010 1:46 PM
Details	State	Insert			Active	11/18/2010 1:46 PM
Dates	Registration Date	Insert			5/12/2010 12:00:00 AM	11/18/2010 1:46 PM
Dates	Signed By Date	Insert			5/4/2010 12:00:00 AM	11/18/2010 1:46 PM
Dates	Start Date	Insert			7/1/2010 12:00:00 AM	11/18/2010 1:46 PM
Terminations	Termination Comments	Insert				11/18/2010 1:46 PM
Terminations	Termination Date	Insert				11/18/2010 1:46 PM
Terminations	Termination Effective Date	Insert				11/18/2010 1:46 PM
Terminations	Termination Reason	Insert				11/18/2010 1:46 PM

340B Drug Pricing Program Database