Healthcare Provider Details

I. General information

NPI: 1659396265
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 06/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 N POST ROAD SUITE B
INDIANAPOLIS IN
46219-4232
US

IV. Provider business mailing address

1250 N POST ROAD SUITE B
INDIANAPOLIS IN
46219-4232
US

V. Phone/Fax

Practice location:
  • Phone: 317-898-2229
  • Fax: 317-898-0838
Mailing address:
  • Phone: 317-898-2229
  • Fax: 317-898-0838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

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