Organization
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC
Active
Other names
Fayette Regional Health System
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE M HENRY (SUPERVISOR PATIENT FINANCIAL SVCS)
(765) 827-7700
Entity
Organization
Contact information
Practice address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331-2833
(765) 827-7704
(765) 827-7726
Mailing address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331-2833
(765) 827-7700
(765) 827-7796
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
10-005059-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100268210
—
IN
Enumeration date
05/18/2010
Last updated
05/18/2010
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