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Updated 7/5/23

Organizational Information - Organization Name

Organizational Information - Doing Business as (if applicable)

Organizational Information - Mailing Address

Organizational Information - City

Organizational Information - State

Lewis County Primary Care Center, Inc.

PrimaryPlus

211 KY 59

Vanceburg

KY

Northeast Valley Health Corporation

Northeast Valley Health Corporation

1172 N. Maclay Ave. San Fernando, CA 91340

San Fernando

CA

Park Duvalle Community Health Center

Park Duvalle Community Health Center

3015 Wilson Ave.

Louisville

KENTUCKY

Holyoke Health Center

230 Maple Street

Holyoke

MA

Peak Vista Community Health Centers

other (please see vendor information form)

3205 N. Academy Blvd.

Colorado Springs

CO

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