Healthcare Provider Details

I. General information

NPI: 1407921794
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 CLEARVISTA DR FAMILY ROOMS
INDIANAPOLIS IN
46256-1695
US

IV. Provider business mailing address

PO BOX 19751
INDIANAPOLIS IN
46219-0751
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-5890
  • Fax: 317-355-2205
Mailing address:
  • Phone: 317-355-5837
  • Fax: 317-904-3929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFERY KIRKHAM
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 317-355-5822