Provider Demographics
NPI:1194772467
Name:COMMUNITY HOSPITALS OF INDIANA, INC
Entity type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-4887
Mailing Address - Street 1:120 W MCKENZIE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-3084
Mailing Address - Country:US
Mailing Address - Phone:317-462-2600
Mailing Address - Fax:317-462-5148
Practice Address - Street 1:120 W MCKENZIE RD
Practice Address - Street 2:SUITE B
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-3084
Practice Address - Country:US
Practice Address - Phone:317-462-2600
Practice Address - Fax:317-462-5148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200325490EMedicaid
INDA8005OtherRR MEDICARE
INDA8005OtherRR MEDICARE