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DSH150074Y COMMUNITY HOSPITALS OF INDIANA, INC. (Terminated)
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Main Details
Name
COMMUNITY HOSPITALS OF INDIANA, INC.
Subdivision Name
Community Imaging Center - East
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150074Y
Medicare Provider Number
150074
Outpatient Facility Provider Number
150074
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
Last Recertification Date
8/31/2016
Termination Date
Termination Reason
4/1/2017
DSH percentage below statutory minimum
Contacts
Authorizing Official
Community Hospital Indianapolis Region
David Kiley, President
(317) 621-9337
Primary Contact
Scott Hufford, Pharmacy Director
(317) 621-5354
Addresses
Street Address
7910 E. Washington STE 150
Indianapolis, IN 46219
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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