Provider Demographics
NPI:1003869645
Name:COMMUNITY HOSPITALS OF INDIANA INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA INC
Other - Org Name:ANDERSON FAMILY HEALTH SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-4887
Mailing Address - Street 1:1601 MEDICAL ARTS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-3459
Mailing Address - Country:US
Mailing Address - Phone:765-298-5700
Mailing Address - Fax:765-298-4913
Practice Address - Street 1:1601 MEDICAL ARTS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3459
Practice Address - Country:US
Practice Address - Phone:765-298-5700
Practice Address - Fax:765-298-4913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2009-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200325490KMedicaid
IN213360Medicare PIN
INDA8271Medicare PIN