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	363LN0000X	Neonatal Nurse Practitioner

General Provider Information

NPI Number	:	1497931786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HOSPITALS OF INDIANA INC

Provider Business Mailing Address
First Line	:	7150 CLEARVISTA DRIVE
Second Line	:	NEONATAL DEPT
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-4699
Country	:	US
Telephone Number	:	317-621-6262
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 CLEARVISTA DRIVE
Second Line	:	NEONATAL DEPT
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-4699
Country	:	US
Telephone Number	:	317-621-6262
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	THOMAS P FISCHER
Credential	:
Telephone Number	:	317-355-4887

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	01/16/2008

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