Healthcare Provider Details

I. General information

NPI: 1205238771
Provider Name (Legal Business Name): COMMUNITY HEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HSE HEALTH CARE CENTER - MEDCHECK SUITE 9669 E 146TH ST
NOBLES VILLE IN
46060
US

IV. Provider business mailing address

1500 NORTH RITTER AVENUE
INDIANAPOLIS IN
46219
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-2462
  • Fax: 317-806-1692
Mailing address:
  • Phone: 317-497-6169
  • Fax: 317-806-1692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVE ZETZL
Title or Position: COMMUNITY EMPLOYER HEALTH
Credential: PHARMD
Phone: 317-621-7598