Organization
COMMUNITY HOSPITALS OF INDIANA INC
Active
Other names
Pendleton Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY KIRKHAM (CFO)
(317) 355-5822
Entity
Organization
Contact information
Practice address
1251 HUNTZINGER BLVD, SUITE 100, PENDLETON, IN 46064-9493
(765) 298-4567
(765) 298-4567
Mailing address
1251 HUNTZINGER BLVD, SUITE 100, PENDLETON, IN 46064-9493
(765) 298-4567
(765) 298-4567
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200849300A
—
IN
01
—
DC6886
RR MEDICARE
IN
Enumeration date
07/21/2006
Last updated
04/20/2010
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