Provider Demographics
NPI:1093302986
Name:MORGAN, FAITH B
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:B
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 FORESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-1905
Mailing Address - Country:US
Mailing Address - Phone:937-251-0752
Mailing Address - Fax:
Practice Address - Street 1:111 FORESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-1905
Practice Address - Country:US
Practice Address - Phone:937-251-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-24
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0076043Medicaid