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General NPI Number Information
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NPI Number | 1093750119
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Entity Type | Organization
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Legal Business Name | PULASKI MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 20531 DARDEN RD
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City | SOUTH BEND
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State | IN
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Zip | 46637-2915
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Country | US
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Telephone | 574-272-0100
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Fax | 574-277-3233
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Provider Business Mailing Address
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Address Line | 20531 DARDEN RD
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City | SOUTH BEND
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State | IN
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Zip | 46637-2915
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Country | US
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Telephone | 574-272-0100
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Fax | 574-277-3233
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | GREGG A MALOTT
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Credential |
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Telephone | 574-946-2103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 06-000073-1
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License Number State | IN
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