# PULASKI MEMORIAL HOSPITAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Majestic Care of Southport
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669410593
- **Authorized official:** MR. GREGG A. MALOTT (CFO)
- **Authorized official phone:** (574) 946-2100

## Contact information

- **Practice address:** 8549 MADISON AVENUE, INDIANAPOLIS, IN 46227-6153
- **Practice address phone:** (317) 881-9164
- **Practice address fax:** (317) 887-4060
- **Mailing address:** 8549 MADISON AVENUE, INDIANAPOLIS, IN 46227-6153
- **Mailing address phone:** (317) 881-9164
- **Mailing address fax:** (317) 887-4060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 05-000151-1 | IN | Yes |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 03/10/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100284060 | — | IN |