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Organization
PULASKI MEMORIAL HOSPITAL
Active
Organization
PULASKI MEMORIAL HOSPITAL
Active
Other names
Majestic Care of Southport
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGG A. MALOTT (CFO)
(574) 946-2100
Entity
Organization
Contact information
Practice address
8549 MADISON AVENUE, INDIANAPOLIS, IN 46227-6153
(317) 881-9164
(317) 887-4060
Mailing address
8549 MADISON AVENUE, INDIANAPOLIS, IN 46227-6153
(317) 881-9164
(317) 887-4060
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05-000151-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100284060
—
IN
Enumeration date
06/03/2006
Last updated
03/10/2022
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