# FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fayette Regional Health System Home Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093774275
- **Authorized official:** RANDALL WHITE (CEO)
- **Authorized official phone:** (765) 827-7987

## Contact information

- **Practice address:** 1941 VIRGINIA AVE, CONNERSVILLE, IN 47331-2833
- **Practice address phone:** (765) 825-0046
- **Practice address fax:** (765) 827-7783
- **Mailing address:** 1941 VIRGINIA AVE, CONNERSVILLE, IN 47331
- **Mailing address phone:** (765) 827-7717
- **Mailing address fax:** (765) 827-7783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 050091491 | IN | Yes |

## Other

- **Enumeration date:** 03/17/2006
- **Last updated:** 07/14/2016