Provider Demographics
NPI:1831501212
Name:COMMUNITY CARE NETWORK, INC
Entity Type:Organization
Organization Name:COMMUNITY CARE NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-947-6113
Mailing Address - Street 1:1500 S LAKE PARK AVE
Mailing Address - Street 2:MANAGED CARE DEPARTMENT
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6638
Mailing Address - Country:US
Mailing Address - Phone:219-947-6113
Mailing Address - Fax:219-947-6503
Practice Address - Street 1:3432 169TH ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46323-2542
Practice Address - Country:US
Practice Address - Phone:219-844-9060
Practice Address - Fax:219-844-6912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty