Provider Demographics
NPI:1710933585
Name:COMMUNITY HOSPITALS OF INDIANA INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA INC
Other - Org Name:POST ROAD FAMILY MEDICINE
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 1:1270 N POST RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4209
Mailing Address - Country:US
Mailing Address - Phone:317-899-5250
Mailing Address - Fax:317-899-8020
Practice Address - Street 1:1270 N POST RD
Practice Address - Street 2:SUITE B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4209
Practice Address - Country:US
Practice Address - Phone:317-899-5250
Practice Address - Fax:317-899-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200325490SMedicaid
INDB3426Medicare PIN
IN200325490SMedicaid