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Organization
PULASKI MEMORIAL HOSPITAL
Active
Organization
PULASKI MEMORIAL HOSPITAL
Active
Other names
Kingston Care Center of Fort Wayne, Kingston Health Center of Fort Wayne
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGG A MALOTT (CHIEF FINANCIAL OFFICER)
(574) 946-2103
Entity
Organization
Contact information
Practice address
1010 W WASHINGTON CENTER RD., FORT WAYNE, IN 46825
(260) 489-2552
(419) 247-2872
Mailing address
1010 W WASHINGTON CENTER RD., FORT WAYNE, IN 46825
(260) 489-2552
(419) 247-2872
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05-000522-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204329
ANTHEM
IN
05
—
100267040
—
IN
05
—
100267040A
—
IN
Enumeration date
10/03/2005
Last updated
04/15/2026
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