Provider Demographics
NPI:1790912301
Name:COMMUNITY HOSPITALS OF INDIANA INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA INC
Other - Org Name:COMMUNITY INFECTIOUS DISEASE
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 1:7430 N SHADELAND AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2036
Mailing Address - Country:US
Mailing Address - Phone:317-841-6420
Mailing Address - Fax:317-841-6422
Practice Address - Street 1:7430 N SHADELAND AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2036
Practice Address - Country:US
Practice Address - Phone:317-841-6420
Practice Address - Fax:317-841-6422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty