Provider Demographics
NPI:1790979748
Name:COMMUNITY HOSPITALS OF INDIANA, INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA, INC
Other - Org Name:SYMPTOM MANAGEMENT GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-621-4887
Mailing Address - Street 1:7229 CLEARVISTA DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1698
Mailing Address - Country:US
Mailing Address - Phone:317-621-4300
Mailing Address - Fax:317-621-4366
Practice Address - Street 1:7229 CLEARVISTA DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1698
Practice Address - Country:US
Practice Address - Phone:317-621-4300
Practice Address - Fax:317-621-4366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000538640OtherANTHEM
IN253950Medicare PIN