Healthcare Provider Details

I. General information

NPI: 1235109778
Provider Name (Legal Business Name): COMMUNITY HOSPITAL SOUTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 E COUNTY LINE ROAD S
INDIANAPOLIS IN
46227-9611
US

IV. Provider business mailing address

6233 RELIABLE PKWY
CHICAGO IL
60686-0062
US

V. Phone/Fax

Practice location:
  • Phone: 317-887-7000
  • Fax:
Mailing address:
  • Phone: 317-355-1411
  • Fax: 317-351-7862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number005109
License Number StateIN

VIII. Authorized Official

Name: MRS. HOLLY MILLARD
Title or Position: SVP FINANCE
Credential:
Phone: 317-355-5860