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Organization
COMMUNITY HOSPITALS OF INDIANA INC
Active
Organization
COMMUNITY HOSPITALS OF INDIANA INC
Active
Parent organization
COMMUNITY HOSPITALS OF INDIANA INC
Other names
Shadeland Family Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY HOSPITALS OF INDIANA INC
Authorized official
JEFFERY KIRKHAM (CFO)
(317) 355-4887
Entity
Organization
Contact information
Practice address
2040 N SHADELAND AVE, SUITE 300, INDIANAPOLIS, IN 46219-1711
(317) 355-3232
(317) 355-6042
Mailing address
3826 SOLUTIONS CTR, CHICAGO, IL 60677-3008
(317) 355-5837
(317) 355-2205
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000107139
ANTHEM
IN
01
—
000000226100
ANTHEM
IN
05
—
100121170A
—
IN
01
—
5942684
AETNA
IN
Enumeration date
11/16/2006
Last updated
10/13/2011
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