Healthcare Provider Details

I. General information

NPI: 1497776231
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 12/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 MEDICAL ARTS BLVD SUITE 300
ANDERSON IN
46011-3439
US

IV. Provider business mailing address

1210 MEDICAL ARTS BLVD SUITE 300
ANDERSON IN
46011-3439
US

V. Phone/Fax

Practice location:
  • Phone: 765-298-4550
  • Fax: 765-298-4950
Mailing address:
  • Phone: 765-298-4550
  • Fax: 765-298-4950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFERY KIRKHAM
Title or Position: CFO
Credential:
Phone: 317-355-5822