340B Drug Pricing Program Database
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CH04898AL LEWIS COUNTY PRIMARY CARE CENTER INC (Active)
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Main Details
Name
LEWIS COUNTY PRIMARY CARE CENTER INC
Subdivision Name
PrimaryPlus Medical Specialties & Residency
Type
HRSA-Funded Health Center
Site ID
BPS-H80-038811
340B ID
CH04898AL
Grant Number
H80CS00106
Additional Details
Current Program Status
Active
Registration Date
7/8/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/10/2024
Last Recertification Date
2/26/2025
Contacts
Authorizing Official
Lewis County Primary Care Center, Inc.
JERRY UGRIN, CEO
(606) 796-3029
Primary Contact
LEWIS COUNTY PRIMARY CARE CENTER, INC.
KAYLA A MUSTARD, 340b Program Manager
(606) 202-7385
Addresses
Street Address
1 W McDonald Pkwy
Maysville, KY 41056-1164
Billing Address
Lewis County Primary Care Center, Inc.
211 KY 59
P.O. Box 550
Vanceburg, KY 41179
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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