Provider Demographics
NPI:1093735276
Name:COMMUNITY HOSPITALS OF INDIANA INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA INC
Other - Org Name:INTERNAL MEDICINE OF CARMEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-5822
Mailing Address - Street 1:11911 N MERIDIAN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-6919
Mailing Address - Country:US
Mailing Address - Phone:317-621-1151
Mailing Address - Fax:317-621-1179
Practice Address - Street 1:11911 N MERIDIAN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-6919
Practice Address - Country:US
Practice Address - Phone:317-621-1151
Practice Address - Fax:317-621-1179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INDF1104OtherMEDICARE RAILROAD
IN200325490YMedicaid
214440Medicare PIN
INDF1104OtherMEDICARE RAILROAD