Healthcare Provider Details

I. General information

NPI: 1043468176
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 11/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11590 N MERIDIAN ST SUITE 170
CARMEL IN
46032-6963
US

IV. Provider business mailing address

11590 N MERIDIAN ST SUITE 170
CARMEL IN
46032-6963
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-2211
  • Fax: 317-621-2218
Mailing address:
  • Phone: 317-621-2211
  • Fax: 317-621-2218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFEREY KIRKHAM
Title or Position: CFO
Credential:
Phone: 317-355-5822