Provider Demographics
NPI:1851651343
Name:FAITH FAMILY HEALTH CARE, LLC
Entity Type:Organization
Organization Name:FAITH FAMILY HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-427-6332
Mailing Address - Street 1:P.O. BOX 878
Mailing Address - Street 2:
Mailing Address - City:BAILEYVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04694-0878
Mailing Address - Country:US
Mailing Address - Phone:207-427-6332
Mailing Address - Fax:207-427-6005
Practice Address - Street 1:163 MAIN ST.
Practice Address - Street 2:
Practice Address - City:BAILEYVILLE
Practice Address - State:ME
Practice Address - Zip Code:04694-0878
Practice Address - Country:US
Practice Address - Phone:207-427-6332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME012593207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty