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DSH150074AW COMMUNITY HOSPITALS OF INDIANA, INC. (Terminated)
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Main Details
Name
COMMUNITY HOSPITALS OF INDIANA, INC.
Subdivision Name
COMMUNITY HEART AND VASCULAR TESTIN
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150074AW
Medicare Provider Number
150074
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/20/2015
Last Recertification Date
9/3/2019
Termination Date
Termination Reason
4/1/2020
Site closure
Contacts
Authorizing Official
Community Hospital Indianapolis Region
David Kiley, President
(317) 621-9337
Primary Contact
Community Health Network
Ashley Marie Harlow, Director, 340B and Strategic Pharmacy Revenue
(317) 621-1791
Addresses
Street Address
8075 N SHADELAND AVE
STE 140
INDIANAPOLIS, IN 46250-2694
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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