Healthcare Provider Details

I. General information

NPI: 1649296229
Provider Name (Legal Business Name): COMMUNITY HOSPITALS OF INDIANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 N MAIN ST
LAPEL IN
46051-9671
US

IV. Provider business mailing address

1675 N MAIN ST
LAPEL IN
46051-9671
US

V. Phone/Fax

Practice location:
  • Phone: 765-534-3127
  • Fax: 317-534-3022
Mailing address:
  • Phone: 765-534-3127
  • Fax: 317-534-3022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFERY KIRKHAM
Title or Position: CFO
Credential:
Phone: 31735535822