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CH04898X LEWIS COUNTY PRIMARY CARE CENTER, INC. (Active)
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Main Details
Name
LEWIS COUNTY PRIMARY CARE CENTER, INC.
Subdivision Name
South Shore Family Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010652
340B ID
CH04898X
Grant Number
H80CS00106
Additional Details
Current Program Status
Active
Registration Date
4/3/2014
Participating Start Date
7/1/2014
Participating Approval Date
4/11/2014
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.
Chad Evans, PharmD
(606) 956-0188
Addresses
Street Address
142 Depot Drive
South Shore, KY 41175
Billing Address
Lewis County Primary Care Center, Inc.
P.O. Box 550
Vanceburg, KY 41179-7647
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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