Organization
ADENA FAYETTE MEDICAL CENTER
Active
Parent organization
FAYETTE COUNTY MEMORIAL HOSPITAL
Other names
Adena Health Center - Fayette
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAYETTE COUNTY MEMORIAL HOSPITAL
Authorized official
LISA M CARLSON (CFO)
(740) 779-7582
Entity
Organization
Contact information
Practice address
1510 COLUMBUS AVE, SUITE 230, WASHINGTON COURT HOUSE, OH 43160-1899
(740) 333-3333
(740) 333-5171
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
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
363983
MEDICARE CCN
—
Enumeration date
07/21/2010
Last updated
05/26/2021
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