MEDICARE: COMMUNITY HEALTH NETWORK

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

General Provider Information

NPI Number	:	1457743809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH NETWORK

Provider Business Mailing Address
First Line	:	1500 N RITTER AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-3027
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 MAIN ST
Second Line	:	STE 255
City	:	SPEEDWAY
State	:	IN
Zip	:	46224-6977
Country	:	US
Telephone Number	:	317-497-6140
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JEFFREY L KIRKHAM
Credential	:
Telephone Number	:	317-497-6140

Provider Enumeration Date	:	02/23/2015
Last Update Date	:	02/23/2015

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Directions to “COMMUNITY HEALTH NETWORK ” Practice Location

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