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Stanford Wellcare Clinic, PLLC

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Company Details

Name: Stanford Wellcare Clinic, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 21 Apr 2021 (4 years ago)
Organization Date: 21 Apr 2021 (4 years ago)
Last Annual Report: 12 May 2024 (a year ago)
Managed By: Members
Organization Number: 1146026
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40484
City: Stanford
Primary County: Lincoln County
Principal Office: 132 Frontier Blvd, Suite 101, Stanford, KY 40484
Place of Formation: KENTUCKY

Registered Agent

Name Role
Imad Haddad Registered Agent

Organizer

Name Role
Imad Haddad Organizer

Member

Name Role
IMAD A HADDAD Member

National Provider Identifier

NPI Number:
1861071219
Certification Date:
2021-08-03

Authorized Person:

Name:
IMAD A HADDAD
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6067275777

Filings

Name File Date
Annual Report 2024-05-12
Annual Report 2023-06-18
Annual Report 2022-06-08

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Sources: Kentucky Secretary of State