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General NPI Number Information
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NPI Number | 1093796179
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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 | 11/07/2005
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 1202 SOUTH 16TH STREET
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City | VINCENNES
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State | IN
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Zip | 47591-4227
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Country | US
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Telephone | 812-882-8292
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Fax | 812-885-6308
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Provider Business Mailing Address
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Address Line | 1202 SOUTH 16TH STREET
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City | VINCENNES
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State | IN
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Zip | 47591-4227
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Country | US
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Telephone | 812-882-8292
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Fax | 812-885-6308
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. GREGG A. MALOTT
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Credential | MBA, CIA
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Telephone | 574-946-2100
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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 |
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License Number State |
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