Organization
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC
Active
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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