Healthcare Provider Details

I. General information

NPI: 1871779157
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 CLEARVISTA DRIVE LABORIST DEPT
INDIANAPOLIS IN
46256-4699
US

IV. Provider business mailing address

7150 CLEARVISTA DRIVE LABORIST DEPT
INDIANAPOLIS IN
46256-4699
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-6262
  • Fax:
Mailing address:
  • Phone: 317-621-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

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