Provider Demographics
NPI:1336119478
Name:COMMUNITY HEALTH NETWORK, INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH NETWORK, INC
Other - Org Name:COMMUNITY HOSPITAL EAST
Other - Org Type:Other Name
Authorized Official - Title/Position:SVP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-5860
Mailing Address - Street 1:6233 RELIABLE PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60686-0062
Mailing Address - Country:US
Mailing Address - Phone:317-355-1411
Mailing Address - Fax:
Practice Address - Street 1:1500 N RITTER AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3027
Practice Address - Country:US
Practice Address - Phone:317-355-1411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN005068282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100375490AMedicaid
IN100385760AMedicaid
IN100375510AMedicaid
000000001502OtherMPLAN PROVIDER NUMBER
IN100385760BMedicaid
8361750OtherPROHEALTH PROVIDER NUMBER
6260365OtherEAST AETNA PROV NUMBER
000000075267OtherNORTH ANTHEM PROV NUMBER
6260800OtherNORTH AETNA PROV. NUMBER
IN100385760BMedicaid
000000001502OtherMPLAN PROVIDER NUMBER