MEDICARE: COMMUNITY HOSPITALS 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
1	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DB6359	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124043716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HOSPITALS OF INDIANA INC

Provider Business Mailing Address
First Line	:	2920 N ARLINGTON AVE
Second Line	:	SUITE B
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-3362
Country	:	US
Telephone Number	:	317-355-9431
Fax Number	:	317-355-9445

Provider Business Practice Location Address
First Line	:	2920 N ARLINGTON AVE
Second Line	:	SUITE B
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-3362
Country	:	US
Telephone Number	:	317-355-9431
Fax Number	:	317-355-9445

Authorized Official
Title or Position	:	CFO
Name	:	JEFFERY KIRKHAM
Credential	:
Telephone Number	:	317-355-5822

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	03/11/2010

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Directions to “COMMUNITY HOSPITALS OF INDIANA INC ” Practice Location

Language	Start Address	Practice Location

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