Provider Demographics
NPI:1659327518
Name:COMMUNITY HOSPITALS OF INDIANA
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA
Other - Org Name:PLUM CREEK FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-4887
Mailing Address - Street 1:1303 N ARLINGTON AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-8300
Mailing Address - Country:US
Mailing Address - Phone:317-355-2800
Mailing Address - Fax:317-355-2828
Practice Address - Street 1:1303 N ARLINGTON AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-8300
Practice Address - Country:US
Practice Address - Phone:317-355-2800
Practice Address - Fax:317-355-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INDB2238OtherRR MEDICARE
IN214380Medicare PIN