# PULASKI MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hickory Creek at Winamac
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720017510
- **Authorized official:** GREGG A MALOTT (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (574) 946-2103

## Contact information

- **Practice address:** 515 E 13TH ST, WINAMAC, IN 46996-1144
- **Practice address phone:** (574) 946-6143
- **Practice address fax:** (574) 946-6186
- **Mailing address:** 515 E 13TH ST, WINAMAC, IN 46996-1144
- **Mailing address phone:** (574) 946-6143
- **Mailing address fax:** (574) 946-6186

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 05-000414-2 | IN | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 08/04/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100288550 | — | IN |