Healthcare Provider Details

I. General information

NPI: 1407809106
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 10/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8205 E 56TH STREET SUITE 100
INDIANAPOLIS IN
46216-1056
US

IV. Provider business mailing address

8205 E 56TH STREET SUITE 100
INDIANAPOLIS IN
46216-1056
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-4044
  • Fax: 317-621-4050
Mailing address:
  • Phone: 317-621-4044
  • Fax: 317-621-4050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

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