1205238771 NPI number — COMMUNITY HEALTH NETWORK

Table of content: (NPI 1205238771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205238771 NPI number — COMMUNITY HEALTH NETWORK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HEALTH NETWORK
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:
Provider Other Organization Name Type Code:
6
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:
1205238771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 NORTH RITTER AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-497-6169
Provider Business Mailing Address Fax Number:
317-806-1692

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HSE HEALTH CARE CENTER - MEDCHECK SUITE
Provider Second Line Business Practice Location Address:
9669 E 146TH ST
Provider Business Practice Location Address City Name:
NOBLES VILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-621-2462
Provider Business Practice Location Address Fax Number:
317-806-1692
Provider Enumeration Date:
09/16/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZETZL
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
Authorized Official Title or Position:
COMMUNITY EMPLOYER HEALTH
Authorized Official Telephone Number:
317-621-7598

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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