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Organization
FAITH HEALTHCARE, INC.
Active
Organization
FAITH HEALTHCARE, INC.
Active
Parent organization
FAITH HEALTHCARE INC
Other names
Stanford Community Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAITH HEALTHCARE INC
Authorized official
LOGAN ROY ANTLE (CEO)
(606) 425-5768
Entity
Organization
Contact information
Practice address
100 JAY ST, STANFORD, KY 40484-7511
(606) 365-1547
(606) 365-8380
Mailing address
521 CRANE RD, SOMERSET, KY 42501-9503
(066) 425-5768
(606) 425-5769
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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