MEDICARE: COMMUNITY HOWARD REGIONAL HEALTH, 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	3416L0300X	Land Ambulance		IN
2	282N00000X	General Acute Care Hospital	060050071	IN

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902878994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HOWARD REGIONAL HEALTH, INC

Provider Business Mailing Address
First Line	:	3500 S LAFOUNTAIN ST
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46902-3803
Country	:	US
Telephone Number	:	765-453-0702
Fax Number	:	765-453-8087

Provider Business Practice Location Address
First Line	:	3500 S LAFOUNTAIN ST
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46902-3803
Country	:	US
Telephone Number	:	765-453-0702
Fax Number	:	765-453-8087

Authorized Official
Title or Position	:	CEO
Name	:	ELIZABETH SHIRENE THARP
Credential	:
Telephone Number	:	765-298-5125

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	02/23/2022

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