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General NPI Number Information
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NPI Number | 1881632800
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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 | 06/03/2006
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Last Update Date | 03/19/2022
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Provider Practice Location Address
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Address Line | 12999 N PENNSYLVANIA ST
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City | CARMEL
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State | IN
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Zip | 46032-5477
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Country | US
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Telephone | 317-848-2448
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Fax | 317-848-5990
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Provider Business Mailing Address
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Address Line | 12999 N. PENNSYLVANIA ST.
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City | CARMEL
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State | IN
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Zip | 46032-5477
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Country | US
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Telephone | 317-848-2448
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Fax | 317-848-5990
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Authorized Official
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Title or Position | CFO
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Name | MR. GREGG A. MALOTT
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Credential |
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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 | 06-001149-1
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License Number State | IN
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