Organization
COMMUNITY HEALTH NETWORK
Active
Other names
Monroe Co. School Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY KIRKHAM (CFO)
(317) 355-5822
Entity
Organization
Contact information
Practice address
524 N FAIRVIEW ST, BLOOMINGTON, IN 47404-3774
(812) 330-7837
Mailing address
524 N. FAIRVIEW ST, BLOOMINGTON, IN 47404-0000
(812) 330-7837
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10-0050681
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
524
ADDRESS
IN
Enumeration date
11/09/2010
Last updated
11/09/2010
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