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Organization
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC.
Active
Organization
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC.
Active
Other names
Brookville Immediate Care
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL WHITE (CEO)
(765) 827-7987
Entity
Organization
Contact information
Practice address
11137 US HIGHWAY 52 SUITE A, BROOKVILLE, IN 47012
(765) 647-5126
(765) 647-5900
Mailing address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331
(765) 825-5131
(765) 827-7796
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
050050591
IN
Other
Enumeration date
03/15/2006
Last updated
03/23/2016
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