Healthcare Provider Details

I. General information

NPI: 1922178516
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 N SHADELAND AVE SUITE 300
INDIANAPOLIS IN
46219-1711
US

IV. Provider business mailing address

3826 SOLUTIONS CTR
CHICAGO IL
60677-3008
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-2122
  • Fax: 317-355-6042
Mailing address:
  • Phone: 317-355-5837
  • Fax: 317-355-2205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFERY KIRKHAM
Title or Position: CFO
Credential:
Phone: 317-355-4887