Provider Demographics
NPI:1033159934
Name:PULASKI COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:PULASKI COMMUNITY HOSPITAL INC
Other - Org Name:LEWISGALE HOSPITAL PULASKI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:HAASKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-994-8311
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:VA
Mailing Address - Zip Code:24301-0759
Mailing Address - Country:US
Mailing Address - Phone:540-994-8100
Mailing Address - Fax:540-994-8333
Practice Address - Street 1:2400 LEE HWY N
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-2326
Practice Address - Country:US
Practice Address - Phone:540-994-8100
Practice Address - Fax:540-994-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA442567OtherWELLPOINT VA/BLUE CROSS