Organization
PULASKI MEMORIAL HOSPITAL
Active
Other names
Heritage Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGG A. MALOTT (CFO)
(574) 946-2100
Entity
Organization
Contact information
Practice address
1201 W BUENA VISTA RD, EVANSVILLE, IN 47710-3336
(812) 429-0700
(812) 429-1849
Mailing address
1201 W BUENA VISTA RD, EVANSVILLE, IN 47710-3336
(812) 429-0700
(812) 429-1849
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05-000043-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097897
ANTHEM
IN
05
—
100290960A
—
IN
Enumeration date
07/20/2005
Last updated
06/28/2023
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