# PULASKI MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kingston Care Center of Fort Wayne, Kingston Health Center of Fort Wayne
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932196177
- **Authorized official:** MR. GREGG A MALOTT (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (574) 946-2103

## Contact information

- **Practice address:** 1010 W WASHINGTON CENTER RD., FORT WAYNE, IN 46825
- **Practice address phone:** (260) 489-2552
- **Practice address fax:** (419) 247-2872
- **Mailing address:** 1010 W WASHINGTON CENTER RD., FORT WAYNE, IN 46825
- **Mailing address phone:** (260) 489-2552
- **Mailing address fax:** (419) 247-2872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 05-000522-1 | IN | Yes |

## Other

- **Enumeration date:** 10/03/2005
- **Last updated:** 04/15/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000204329 | ANTHEM | IN |
| 05 | — | 100267040 | — | IN |
| 05 | — | 100267040A | — | IN |