Healthcare Provider Details

I. General information

NPI: 1992575807
Provider Name (Legal Business Name): FAITH HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 BOGLE ST STE 3
SOMERSET KY
42503-2870
US

IV. Provider business mailing address

PO BOX 969
SOMERSET KY
42502-0969
US

V. Phone/Fax

Practice location:
  • Phone: 606-425-5768
  • Fax:
Mailing address:
  • Phone: 606-425-5768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: CORY RYAN
Title or Position: CMO
Credential: MD
Phone: 606-396-3534