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Organization
ADENA FAYETTE MEDICAL CENTER
Active
Organization
ADENA FAYETTE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M CARLSON (CFO)
(740) 779-7582
Entity
Organization
Contact information
Practice address
1430 COLUMBUS AVE, WASHINGTON COURT HOUSE, OH 43160-1703
(740) 333-2705
(740) 333-2998
Mailing address
1450 COLUMBUS AVE, SUITE B 6-7-8, WASHINGTON COURT HOUSE, OH 43160-3701
(740) 333-2236
(740) 333-3881
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
1168
OH
282NC0060X
Critical Access Hospital
Primary
1168
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000244918
ANTHEM INSURANCE
—
01
—
0066355
AETNA INSURANCE
—
01
—
0653982
CIGNA INSURANCE
—
05
—
2675403
—
OH
01
—
316008062
ALL OTHER PAYERS
—
01
—
316008062044
MEDICAL MUTUAL INSURANCE
—
01
—
34
CENTRAL BENEFITS INSURANC
—
01
—
5020091
UNITED HEALTHCARE INSURAN
—
Enumeration date
08/31/2006
Last updated
06/02/2021
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