MEDICARE: PULASKI MEMORIAL HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	14-000215-1	IN

General Provider Information

NPI Number	:	1336548353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PULASKI MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	6050 S CR 800 E-92
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46814-9201
Country	:	US
Telephone Number	:	260-625-3545
Fax Number	:	260-625-4993

Provider Business Practice Location Address
First Line	:	6050 S CR 800 E-92
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46814-9201
Country	:	US
Telephone Number	:	260-625-3545
Fax Number	:	260-625-4993

Authorized Official
Title or Position	:	DIRECTOR OF BUSINESS DEVELOPMENT
Name	:	MR. GREGG A. MALOTT
Credential	:
Telephone Number	:	574-946-2100

Provider Enumeration Date	:	08/14/2014
Last Update Date	:	05/02/2019

Similar Medicare Providers

1518939404 — RENAISSANCE HEALTH CARE LLC
Practice Location Address:

6050 S 800 E-92
FORT WAYNE, IN
46814-9201

Practice Phone: 260-625-3545
Practice Fax: 260-625-3328

1023006640 — RICHARD M DAVIS MD PA
Practice Location Address:

9201 CYPRESS LAKE DR
FORT MYERS, FL
33919-4941

Practice Phone: 239-481-3343
Practice Fax:

1750379277 — DR. RICHARD M DAVIS MD
Practice Location Address:

9201 CYPRESS LAKE DR
FORT MYERS, FL
33919-4941

Practice Phone: 239-936-8686
Practice Fax: 239-936-2532

1932199700 — MRS. KELLY SMITH
Practice Location Address:

9201 CYPRESS LAKE DR
FORT MYERS, FL
33919-4941

Practice Phone: 239-481-3343
Practice Fax: 239-482-5227

1235120619 — RICHARD M DAVIS MD PA
Practice Location Address:

9201 CYPRESS LAKE DR
FORT MYERS, FL
33919-4941

Practice Phone: 239-481-8171
Practice Fax: 239-482-5227

1134191976 — DR. SUNIL MOHAN MALKANI MD
Practice Location Address:

9201 CYPRESS LAKE DR
FORT MYERS, FL
33919-9310

Practice Phone: 239-324-4888
Practice Fax: 877-717-0096

Directions to “PULASKI MEMORIAL HOSPITAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.