Provider Demographics
NPI:1053346437
Name:COMMUNITY HOSPITALS OF INDIANA
Entity type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:317-355-2050
Mailing Address - Street 1:1400 N RITTER AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-3052
Mailing Address - Country:US
Mailing Address - Phone:317-355-2050
Mailing Address - Fax:317-355-2051
Practice Address - Street 1:1400 N RITTER AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3052
Practice Address - Country:US
Practice Address - Phone:317-355-2050
Practice Address - Fax:317-355-2051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200519540AMedicaid
IN5469970001Medicare NSC
IN200519540AMedicaid