| Organization Name: | FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC. |
| NPI Number: | 1073582730 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RANDALL WHITE (CEO) |
| Mailing Address: | 11137 Us Highway 52 Suite A Brookville |
| State: | IN US |
| Postal Code: | 47012 |
| Phone Number: | 7656475126 |
| Fax Number: | 7656475900 |
| NPI Enumeration Date: | 03/15/2006 |
| NPI Last Update Date: | 03/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | 050050591 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |