Covered Entity Details

CH048980 LEWIS COUNTY PRIMARY CARE CENTER, INC. (Active)

Main Details

Name

LEWIS COUNTY PRIMARY CARE CENTER, INC.

Subdivision Name

Lewis County Primary Care Center, Inc.

Type

HRSA-Funded Health Center

Site ID

BPS-H80-001194

340B ID

CH048980

Grant Number

H80CS00106

Additional Details

Current Program Status

Active

Registration Date

1/1/1999

Participating Start Date

1/1/1999

Participating Approval Date

4/25/2005

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

211 KY 59
Building A
VANCEBURG, KY 41179

Billing Address

LEWIS COUNTY PRIMARY CARE CENTER, INC.
PO BOX 550
VANCEBURG, KY 41179

Comment	Last Updated On
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1 Item 1 to 2 of 2 Page: of 1 Page size:
3/16/09 ADDR CHANGE(WAS RTE 3,BOX 317 P.O. BOX 550) - CORRECTED ENTITY NAME, NEW CONTACT, 4/25/05 - NEW BILL TO, NEW CONTACT. 7/5/11 - CHANGED CONTACT NAME FROM KAREN BENNION, KBENNION@LCPCC.ORG	07/05/2011
3/16/09 ADDR CHANGE(WAS RTE 3,BOX 317 P.O. BOX 550) - CORRECTED ENTITY NAME, NEW CONTACT, 4/25/05 - NEW BILL TO, NEW CONTACT. 7/5/11 - CHANGED CONTACT NAME FROM KAREN BENNION, KBENNION@LCPCC.ORG	07/05/2011

340B Drug Pricing Program Database