LINCOLN COUNTY PRIMARY CARE CENTER, INC (NPI# 1003274580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003274580 |
| Entity Type | Organization |
| Organization Name | LINCOLN COUNTY PRIMARY CARE CENTER, INC |
| Other Organization Name | MUSTANG HEALTH CENTER |
| Practice Address |
267 Midway Rd Alum Creek WV 25003-9591 |
| Mailing Address |
7400 Lynn Ave Hamlin WV 25523-1138 |
| Practice Telephone | 3047561007 |
| Practice Fax Number | 3047561010 |
| Mailing Telephone | 3048245806 |
| Mailing Fax Number | 3048245885 |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2018-10-02 |
| Authorized Official Name | LISA LEACH (CEO) |
| Authorized Official Telephone | 3048245806 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
2317-5033 | WV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 1003274580 | 05 |
| Other Name | Type Code |
|---|---|
| Mustang Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801254388 | Lincoln County Primary Care Center, Inc | Clinic/Center | 59 Vanatters Crk, Ranger, WV 25557-9719 | 2016-01-29 |
| 1942509856 | Lincoln County Primary Care Center, Inc | Clinic/Center | 5490 State Route 10, Salt Rock, WV 25559-9736 | 2011-03-17 |
| 1023331220 | Lincoln County Primary Care Center, Inc | Clinic/Center | 122 Nick Savas Drive, Logan, WV 25601-3468 | 2010-03-03 |
| 1962583054 | Lincoln County Primary Care Center, Inc | Clinic/Center | 81 Lincoln Panther Way, Hamlin, WV 25523-1169 | 2006-10-17 |
| 1447619416 | Lincoln County Primary Care Center, Inc | Clinic/Center | 1 Pioneer Path, Man, WV 25635-1235 | 2016-02-18 |
| Street Address |
267 MIDWAY RD |
| City | ALUM CREEK |
| State | WV |
| Zip Code | 25003-9591 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093327793 | Kathy Marie Davis | Technician | 71 Tyler Lane, Alum Creek, WV 25003 | 2020-08-24 |
| 1992337869 | Ridgeline Services Consulting Services, LLC | Counselor | 2162 Childress Road, Alum Creek, WV 25003 | 2020-02-10 |
| 1831283381 | Alum Creek Medical Center, Inc. | Family Medicine | 2150 Childress Road, Alum Creek, WV 25003 | 2006-10-02 |
| 1609906726 | Scott Franklin Smith | Family Medicine | 2150 Childress Road, Alum Creek, WV 25003 | 2007-03-07 |
| 1396920138 | Alum Creek Medical Center, Inc. | Clinical Medical Laboratory | 2150 Childress Road, Alum Creek, WV 25003-0040 | 2007-12-28 |
| 1831612977 | Celeste K Goodnight | Nurse Practitioner | 2150 Alum Creek Medical Center, Alum Creek, WV 25003-1750 | 2017-07-20 |
| 1891305967 | Rosalena Kirk | Technician | 567 Jessie Ln, Alum Creek, WV 25003-5452 | 2020-08-04 |
| 1720698871 | Madora Gibson | Technician | 836 Gibson Rd, Alum Creek, WV 25003-5481 | 2020-08-04 |
| 1598372658 | Tabitha Rennea Murphy | Technician | 256 Kanawha Ln, Alum Creek, WV 25003-5607 | 2020-09-23 |
| 1023627601 | Stephan Wright | Technician | 696 Midway Rd, Alum Creek, WV 25003-8106 | 2020-07-29 |
| Find all providers in zip 25003 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1740836873 | Williamson Health & Wellness Center Inc | Clinic/Center | 5 Parkway Dr, Williamson, WV 25661-3428 | 2019-08-14 |
| 1699321729 | Williamson Health & Wellness Center Inc | Clinic/Center | 50 Panther Blvd, Williamson, WV 25661-7441 | 2019-08-14 |
| 1083260129 | Williamson Health & Wellness Center Inc | Clinic/Center | 300 Blue Devil Lane, Kermit, WV 25661 | 2019-08-14 |
| 1225684731 | Williamson Health & Wellness Center Inc | Clinic/Center | 1000 King Coal Hwy, Delbarton, WV 25670-9529 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
| City | ALUM CREEK |
| Zip Code | 25003 |
Please comment or provide details below to improve the information on LINCOLN COUNTY PRIMARY CARE CENTER, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.