Organization
PULASKI MEMORIAL HOSPITAL
Active
Other names
PULASKI MEMORIAL HOSPITAL FIRST STEPS
Organization subpart
No
Provider details
NPI number
Authorized official
GREGG MALOTT (VP OF BUSINESS DEVELOPMENT)
(574) 946-2103
Entity
Organization
Contact information
Practice address
616 E 13TH ST, WINAMAC, IN 46996-1117
(574) 946-2100
(574) 946-2129
Mailing address
616 E 13TH ST, PO BOX 279, WINAMAC, IN 46996-1117
(574) 946-2100
(574) 946-2129
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22000181
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200714230A
—
IN
Enumeration date
07/26/2007
Last updated
03/13/2020
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