FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC.; NPI #1073582730

Contact Information

FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC.

11137 US HIGHWAY 52 SUITE A
BROOKVILLE, IN 47012

Phone: 765-647-5126
Fax: 765-647-5900
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Urgent Care	261QU0200X

Indicates primary specialty

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NPI Profile & details for FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC.

NPI Number 1073582730

LBN Legal business name FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC.

Authorized official RANDALL WHITE - (CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/15/2006

Last updated 03/23/2016 - About 10 years ago

Identifiers

IN	License #	050050591
IN	Medicaid	200061320A
OH	Medicaid	2320330

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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