MEDICARE: LINCOLN COUNTY PRIMARY CARE CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1033084124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINCOLN COUNTY PRIMARY CARE CENTER INC

Provider Business Mailing Address
First Line	:	7400 LYNN AVE
Second Line	:
City	:	HAMLIN
State	:	WV
Zip	:	25523-1138
Country	:	US
Telephone Number	:	304-824-5806
Fax Number	:	304-824-5806

Provider Business Practice Location Address
First Line	:	5027 HELENA AVE
Second Line	:
City	:	DELBARTON
State	:	WV
Zip	:	25670-1301
Country	:	US
Telephone Number	:	304-475-1761
Fax Number	:	304-475-1762

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	LETITIA ANN WEAVER-SCITES
Credential	:
Telephone Number	:	304-824-5806

Provider Enumeration Date	:	10/08/2025
Last Update Date	:	10/08/2025

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