Healthcare Provider Details

I. General information

NPI: 1538184031
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 08/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S 19TH ST
ELWOOD IN
46036-2941
US

IV. Provider business mailing address

1515 S 19TH ST
ELWOOD IN
46036-2941
US

V. Phone/Fax

Practice location:
  • Phone: 765-552-7346
  • Fax:
Mailing address:
  • Phone: 765-552-7346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS FISCHER
Title or Position: CFO
Credential:
Phone: 317-355-4887