Organization
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC
Active
Other names
Fayette Regional Health System Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL WHITE (CEO)
(765) 827-7987
Entity
Organization
Contact information
Practice address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331-2833
(765) 825-0046
(765) 827-7783
Mailing address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331
(765) 827-7717
(765) 827-7783
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
050091491
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100263600A
—
IN
Enumeration date
03/17/2006
Last updated
07/14/2016
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