Provider Demographics
NPI:1427001387
Name:COMMUNITY HOSPITALS OF INDIANA, INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA, INC
Other - Org Name:MEDCHECK ANDERSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KIRKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-5822
Mailing Address - Street 1:1030 S SCATTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-4235
Mailing Address - Country:US
Mailing Address - Phone:765-644-5025
Mailing Address - Fax:765-643-4534
Practice Address - Street 1:1030 S SCATTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-4235
Practice Address - Country:US
Practice Address - Phone:765-644-5025
Practice Address - Fax:765-643-4534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN142570Medicare PIN