Provider Demographics
NPI:1679545966
Name:COMMUNITY HEALTH NETWORK, INC.
Entity type:Organization
Organization Name:COMMUNITY HEALTH NETWORK, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
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 1:6233 RELIABLE PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60686-0062
Mailing Address - Country:US
Mailing Address - Phone:317-355-4111
Mailing Address - Fax:
Practice Address - Street 1:7165 CLEARVISTA WAY
Practice Address - Street 2:SUITE D2
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-4621
Practice Address - Country:US
Practice Address - Phone:317-355-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN005068273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
8361750OtherPROHEALTH PROVIDER NUMBER
IN100385760BMedicaid
000000075267OtherANTHEM PROVIDER NUMBER
000000001502OtherMPLAN PROVIDER NUMBER
6260365OtherNORTH AETNA PROV NUMBER
IN15S074Medicare Oscar/Certification
8361750OtherPROHEALTH PROVIDER NUMBER