Organization
FAYETTE MEDICAL CENTER HOMECARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA L. PROFFITT (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
102 2ND AVE SE, FAYETTE, AL 35555-2717
(205) 932-5961
(205) 932-8054
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115614
—
AL
Enumeration date
10/24/2008
Last updated
05/24/2024
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