Healthcare Provider Details

I. General information

NPI: 1821247479
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 09/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7120 CLEARVISTA DR SUITE 3700
INDIANAPOLIS IN
46256-1621
US

IV. Provider business mailing address

7120 CLEARVISTA DR SUITE 3700
INDIANAPOLIS IN
46256-1621
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-0110
  • Fax: 317-621-0103
Mailing address:
  • Phone: 317-621-0110
  • Fax: 317-621-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number
License Number State

VIII. Authorized Official

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