# COMMUNITY HOSPITALS OF INDIANA INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** County Line Medical Pavilion
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073531976
- **Authorized official:** JEFFERY KIRKHAM (CFO)
- **Authorized official phone:** (317) 355-5822

## Contact information

- **Practice address:** 333 E COUNTY LINE RD, SUITE B, GREENWOOD, IN 46143-1046
- **Practice address phone:** (317) 497-6333
- **Practice address fax:** (317) 497-6334
- **Mailing address:** 333 E COUNTY LINE RD, SUITE B, GREENWOOD, IN 46143-1046
- **Mailing address phone:** (317) 497-6333
- **Mailing address fax:** (317) 497-6334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 03/29/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200325490B | — | IN |