Organization
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC
Active
Other names
Fayette Regional Health System Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN M THOMPSON (CONTROLLER)
(765) 827-7709
Entity
Organization
Contact information
Practice address
420 W 24TH ST, CONNERSVILLE, IN 47331-2947
(765) 827-7717
(765) 827-7783
Mailing address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331-2833
(765) 827-7717
(765) 827-7783
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
050052991
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200148780A
—
IN
Enumeration date
03/18/2006
Last updated
11/12/2009
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