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General NPI Number Information
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NPI Number | 1831163906
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Entity Type | Organization
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Legal Business Name | LINCOLN COUNTY PRIMARY CARE CENTER INC
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 7400 LYNN AVE
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City | HAMLIN
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State | WV
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Zip | 25523-1138
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Country | US
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Telephone | 304-824-6337
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Fax | 304-824-6333
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Provider Business Mailing Address
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Address Line | 7400 LYNN AVE
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City | HAMLIN
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State | WV
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Zip | 25523-1138
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Country | US
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Telephone | 304-824-6337
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Fax | 304-824-6333
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Authorized Official
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Title or Position | CEO
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Name | LISA LEACH
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Credential | RPH., PHARM. D.
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Telephone | 304-824-5806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | SP0552327
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License Number State | WV
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