1336119478 NPI number — COMMUNITY HEALTH NETWORK, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336119478 NPI number — COMMUNITY HEALTH NETWORK, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HEALTH NETWORK, 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:
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:
1336119478
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6233 RELIABLE PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60686-0062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-355-1411
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 N RITTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46219-3027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-355-1411
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MILLARD
Authorized Official First Name:
HOLLY
Authorized Official Middle Name:
Authorized Official Title or Position:
SVP FINANCE
Authorized Official Telephone Number:
317-355-5860

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  005068 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100375490A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100385760A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100375510A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000001502 . This is a "MPLAN PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100385760B , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8361750 . This is a "PROHEALTH PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6260365 . This is a "EAST AETNA PROV NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000075267 . This is a "NORTH ANTHEM PROV NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6260800 . This is a "NORTH AETNA PROV. NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010044900 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com