Provider Demographics
NPI:1164603395
Name:COMMUNITY HOSPITAL OF INDIANAPOLIS
Entity Type:Organization
Organization Name:COMMUNITY HOSPITAL OF INDIANAPOLIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:317-669-7434
Mailing Address - Street 1:826 PAWTUCKET DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8874
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:317-669-7434
Practice Address - Street 1:826 PAWTUCKET DR
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-8874
Practice Address - Country:US
Practice Address - Phone:312-621-5494
Practice Address - Fax:317-669-7434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28085179A282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital