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NPI Code Detail

MEDICARE: COMMUNITY HOSPITAL OF INDIANA, INC

MEDICARE: COMMUNITY HOSPITAL OF INDIANA, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1063465946
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HOSPITAL OF INDIANA, INC
Provider Business Mailing Address
First Line : 8177 CLEARVISTA PKWY
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1662
Country : US
Telephone Number : 317-621-7801
Fax Number : 317-621-7205
Provider Business Practice Location Address
First Line : 8177 CLEARVISTA PKWY
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1662
Country : US
Telephone Number : 317-621-7801
Fax Number : 317-621-7205
Authorized Official
Title or Position : CFO
Name : MR. JEFFERY L KIRKHAM
Credential :
Telephone Number : 317-355-5822
Provider Enumeration Date : 05/19/2006
Last Update Date : 06/16/2010

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Directions to “COMMUNITY HOSPITAL OF INDIANA, INC ” Practice Location

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