Healthcare Provider Details

I. General information

NPI: 1548336456
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N RITTER AVE LOWER LEVEL PHYSICIAN BILLING SERVICES
INDIANAPOLIS IN
46219-3027
US

IV. Provider business mailing address

PO BOX 19751 LOWER LEVEL REVENUE CYCLE
INDIANAPOLIS IN
46219-0751
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-5837
  • Fax: 317-355-2205
Mailing address:
  • Phone: 317-355-5837
  • Fax: 317-355-2205

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: 317-355-4887