# FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brookville Immediate Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073582730
- **Authorized official:** RANDALL WHITE (CEO)
- **Authorized official phone:** (765) 827-7987

## Contact information

- **Practice address:** 11137 US HIGHWAY 52 SUITE A, BROOKVILLE, IN 47012
- **Practice address phone:** (765) 647-5126
- **Practice address fax:** (765) 647-5900
- **Mailing address:** 1941 VIRGINIA AVE, CONNERSVILLE, IN 47331
- **Mailing address phone:** (765) 825-5131
- **Mailing address fax:** (765) 827-7796

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | 050050591 | IN | Yes |

## Other

- **Enumeration date:** 03/15/2006
- **Last updated:** 03/23/2016