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DSH150169Q COMMUNITY HOSPITAL OF INDIANA INC. (Active)
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Main Details
Name
COMMUNITY HOSPITAL OF INDIANA INC.
Subdivision Name
Cancer Center Carmel - CRCC Carmel
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150169Q
Medicare Provider Number
150169
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/1/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/8/2024
Last Recertification Date
Contacts
Authorizing Official
Community Health Network
Beth Tharp, SVP/President of Hospital Services
(765) 298-5125
Primary Contact
Community Health Network
Ashley Marie Harlow, Director, 340B and Strategic Pharmacy Revenue
(317) 621-1791
Addresses
Street Address
11911 N Meridian St
170
Carmel, IN 46032
Billing Address
Community Health Network Carmel Cancer Pavilion
11911 N Meridian St
Carmel, IN 46032
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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