1437176468 NPI number — COMMUNITY HOSPITALS OF INDIANA INC

Table of content: (NPI 1437176468)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437176468 NPI number — COMMUNITY HOSPITALS OF INDIANA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HOSPITALS OF INDIANA INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
OLIO ROAD FAMILY CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437176468
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13121 OLIO RD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
FISHERS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46037-7240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-621-1300
Provider Business Mailing Address Fax Number:
317-621-1310

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13121 OLIO RD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
FISHERS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46037-7240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-621-1300
Provider Business Practice Location Address Fax Number:
317-621-1310
Provider Enumeration Date:
07/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KIRKHAM
Authorized Official First Name:
JEFFERY
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
317-355-5822

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DD8792 . This is a "RR MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200526840A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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