Provider Demographics
NPI:1093796179
Name:PULASKI MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:PULASKI MEMORIAL HOSPITAL
Other - Org Name:GENTLE CARE STRATEGIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CIA
Authorized Official - Phone:574-946-2100
Mailing Address - Street 1:1202 SOUTH 16TH STREET
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-4227
Mailing Address - Country:US
Mailing Address - Phone:812-882-8292
Mailing Address - Fax:812-885-6308
Practice Address - Street 1:1202 SOUTH 16TH STREET
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-4227
Practice Address - Country:US
Practice Address - Phone:812-882-8292
Practice Address - Fax:812-885-6308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100291370AMedicaid
IN155519Medicare Oscar/Certification