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Organization
COMMUNITY HOSPITALS OF INDIANA INC
Active
Organization
COMMUNITY HOSPITALS OF INDIANA INC
Active
Other names
Northside Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY KIRKHAM (CFO)
(317) 355-5822
Entity
Organization
Contact information
Practice address
8202 CLEARVISTA PKWY, SUITE 6B, INDIANAPOLIS, IN 46256-1442
(317) 579-1670
(317) 579-1680
Mailing address
8202 CLEARVISTA PKWY, SUITE 6B, INDIANAPOLIS, IN 46256-1442
(317) 579-1670
(317) 579-1680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200406960 P
—
IN
05
—
200406960A
—
IN
01
—
DD2062
MEDICARE RAILROAD
IN
Enumeration date
07/16/2006
Last updated
12/17/2010
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