Organization
FAYETTE MEDICAL CENTER
Active
Other names
HOSPICE OF FAYETTE MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
KERI HENLEY HINDMAN (PATIENT ACCOUNTS DIRECTOR)
(205) 759-7378
Entity
Organization
Contact information
Practice address
120 15TH STREET NW, FAYETTE, AL 35555-1526
(205) 932-8057
(205) 932-8054
Mailing address
PO BOX 710, 1653 TEMPLE AVENUE NORTH, FAYETTE, AL 35555-0710
(205) 932-5966
(205) 932-8054
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
11656
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011549
BLUE CROSS
AL
05
—
PIC1540E
—
AL
Enumeration date
10/24/2006
Last updated
01/12/2021
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