Provider Demographics
NPI:1508970575
Name:COMMUNITY HOSPITALS OF INDIANA
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA
Other - Org Name:CIRCLE CITY PEDIAITRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-4887
Mailing Address - Street 1:4037 S. ARBOR LANE
Mailing Address - Street 2:SUITE D
Mailing Address - City:NEW PALESTINE
Mailing Address - State:IN
Mailing Address - Zip Code:46163
Mailing Address - Country:US
Mailing Address - Phone:317-621-9652
Mailing Address - Fax:
Practice Address - Street 1:4037 S. ARBOR LANE
Practice Address - Street 2:SUITE D
Practice Address - City:NEW PALESTINE
Practice Address - State:IN
Practice Address - Zip Code:46163
Practice Address - Country:US
Practice Address - Phone:317-621-9652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN214400Medicare PIN