340B Drug Pricing Program Database
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DSH150074BA COMMUNITY HOSPITALS OF INDIANA, INC. (Terminated)
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Main Details
Name
COMMUNITY HOSPITALS OF INDIANA, INC.
Subdivision Name
COMMUNITY N SHADELAND AVE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150074BA
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
11/16/2017
Termination Date
Termination Reason
10/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Community Hospital Indianapolis Region
David Kiley, President
(317) 621-9337
Primary Contact
Community Health Network
Whitney Sweatt, Pharmacy Director
(317) 355-5747
Addresses
Street Address
8075 N SHADELAND AVE
STE 130
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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