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LOGAN PRIMARY CARE SERVICE CORP.
NPI 1023123346
Clinic/Center - Rural Health in West Frankfort, IL

Active since August 19, 2006CLIA 14D0963522 · Waiver
502 W ST LOUIS, WEST FRANKFORT, IL 62896(618) 997-3400(618) 932-3797 Get Directions Write a Review

NPPES record last updated: March 16, 2012. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Logan Primary Care Service Corp. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LOGAN PRIMARY CARE SERVICE CORP. (NPI 1023123346) is a healthcare organization registered as a rural health in West Frankfort, Illinois and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through March 18, 2027 and lists Tara G Deaton, Administrator, as its authorized official.

NPPES Registry Identity

NPI1023123346
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameLOGAN PRIMARY CARE SERVICE CORP.
Location Address502 W ST LOUISWest Frankfort, IL 62896
Mailing Address405 Rushing DriveHerrin, IL 62948 · (618) 993-3300 · Fax (618) 997-6626
Phone(618) 997-3400
Fax(618) 932-3797
Organization SubpartNo
Authorized OfficialTara G DeatonAdministrator · (618) 993-3300
Enumeration DateAugust 19, 2006
Last NPPES UpdateMarch 16, 2012
✔ NPI 1023123346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in IL · 036099669
502 W ST LOUIS, West Frankfort, IL 62896
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Other Identifiers 5

Medicare PIN148969IL
Other10019630IL · Blue Cross Blue Shield
Medicare UPINH10113IL
Medicaid148969IL
Medicare OSCAR/certification148969IL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0963522

Logan Primary Care Services Southern Illinois Medical Services · West Frankfort, IL
Active · expires Mar 18, 2027
CLIA Number14D0963522
Laboratory TypeRural Health Clinic
Certificate Effective DateMarch 19, 2025
Certificate Expiration DateMarch 18, 2027
Laboratory DirectorMark Korte
Laboratory Phone(618) 993-3300
Laboratory LocationLogan Primary Care Services Southern Illinois Medical Services502 W St Louis St, West Frankfort, IL 62896
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Logan Primary Care Service Corp.'s NPI number?

The NPI number for Logan Primary Care Service Corp. is 1023123346. It was assigned to this organization in the NPPES registry on August 19, 2006.

Where is Logan Primary Care Service Corp. located?

Logan Primary Care Service Corp. is located at 502 W St Louis, West Frankfort, IL 62896. The listed phone number is (618) 997-3400.

What is Logan Primary Care Service Corp.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Logan Primary Care Service Corp. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0963522) is associated with this NPI, valid through March 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Logan Primary Care Service Corp. was last updated on March 16, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.