Provider Demographics
NPI:1972500452
Name:COMMUNITY HOSPITAL OF ANDERSON & MADISON COUNTY, INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITAL OF ANDERSON & MADISON COUNTY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-5860
Mailing Address - Street 1:6233 RELIABLE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60686-0001
Mailing Address - Country:US
Mailing Address - Phone:765-298-3300
Mailing Address - Fax:765-298-5800
Practice Address - Street 1:1515 N MADISON AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3453
Practice Address - Country:US
Practice Address - Phone:765-298-3300
Practice Address - Fax:765-298-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100102820AMedicaid
IN200817400AMedicaid
IN0745740001OtherMEDICARE PART B DME
IN200073560AMedicaid
IN000000097753OtherANTHEM
IN100269520AMedicaid