Provider Demographics
NPI:1417173337
Name:COMMUNITY HOSPITALS OF INDIANA
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA
Other - Org Name:COMMUNITY OB LABORISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR ANCILLARY AR
Authorized Official - Prefix:MS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:317-621-9536
Mailing Address - Street 1:1500 N RITTER AVE
Mailing Address - Street 2:PATIENT ACCTS, PBS
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-3027
Mailing Address - Country:US
Mailing Address - Phone:317-355-2223
Mailing Address - Fax:317-355-2205
Practice Address - Street 1:7150 CLEARVISTA DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1695
Practice Address - Country:US
Practice Address - Phone:317-355-2223
Practice Address - Fax:317-355-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN=========OtherCOMMERCIAL