MEDICARE: COMMUNITY HOSPITALS OF INDIANA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DA9449	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740204163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HOSPITALS OF INDIANA INC

Provider Business Mailing Address
First Line	:	1201 N POST RD
Second Line	:	SUITE 2
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4225
Country	:	US
Telephone Number	:	317-355-6780
Fax Number	:	317-355-6782

Provider Business Practice Location Address
First Line	:	1201 N POST RD
Second Line	:	SUITE 2
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4225
Country	:	US
Telephone Number	:	317-355-6780
Fax Number	:	317-355-6782

Authorized Official
Title or Position	:	CFO
Name	:	JEFFERY KIRKHAM
Credential	:
Telephone Number	:	317-355-5822

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	08/06/2010

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Directions to “COMMUNITY HOSPITALS OF INDIANA INC ” Practice Location

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