Provider Demographics
NPI:1578646741
Name:COMMUNITIY HOSPITALS OF INDIANA INC
Entity Type:Organization
Organization Name:COMMUNITIY HOSPITALS OF INDIANA INC
Other - Org Name:GENERAL SURGEONS OF CENTRAL INDIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-5822
Mailing Address - Street 1:1400 N RITTER AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-3049
Mailing Address - Country:US
Mailing Address - Phone:317-621-7527
Mailing Address - Fax:317-355-7648
Practice Address - Street 1:1400 N RITTER AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3049
Practice Address - Country:US
Practice Address - Phone:317-621-7527
Practice Address - Fax:317-355-7648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200840450Medicaid
IN200840450Medicaid