Community Hospital North | |
7165 Clearvista Way Suite D2 Indianapolis IN 46256-4621 | |
(317) 355-4111 | |
Not Available |
Full Name | Community Hospital North |
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Speciality | Psychiatric Unit |
Location | 7165 Clearvista Way, Indianapolis, Indiana |
Authorized Official Name and Position | Thomas P Fischer (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 3173554887 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Community Hospital North 6233 Reliable Pkwy Chicago IL 60686-0062 Ph: (317) 355-4111 | Community Hospital North 7165 Clearvista Way Suite D2 Indianapolis IN 46256-4621 Ph: (317) 355-4111 |
NPI Number | 1679545966 |
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Provider Enumeration Date | 02/02/2006 |
Last Update Date | 06/23/2015 |
Medicare PECOS PAC ID | 6800978198 |
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Medicare Enrollment ID | O20091109000498 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679545966 | NPI | - | NPPES |
8361750 | Other | PROHEALTH PROVIDER NUMBER | |
100385760B | Medicaid | IN | |
000000075267 | Other | ANTHEM PROVIDER NUMBER | |
000000001502 | Other | MPLAN PROVIDER NUMBER | |
6260365 | Other | NORTH AETNA PROV NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
273R00000X | Psychiatric Unit | 005068 (Indiana) | Primary |
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