# PULASKI MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609875640
- **Authorized official:** MR. GREGG A. MALOTT (CFO)
- **Authorized official phone:** (574) 946-2100

## Contact information

- **Practice address:** 1201 W BUENA VISTA RD, EVANSVILLE, IN 47710-3336
- **Practice address phone:** (812) 429-0700
- **Practice address fax:** (812) 429-1849
- **Mailing address:** 1201 W BUENA VISTA RD, EVANSVILLE, IN 47710-3336
- **Mailing address phone:** (812) 429-0700
- **Mailing address fax:** (812) 429-1849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 05-000043-1 | IN | Yes |

## Other

- **Enumeration date:** 07/20/2005
- **Last updated:** 06/28/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000097897 | ANTHEM | IN |
| 05 | — | 100290960A | — | IN |