PULASKI MEMORIAL HOSPITAL (NPI# 1881816148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881816148 |
Entity Type | Organization |
Organization Name | PULASKI MEMORIAL HOSPITAL |
Other Organization Name | BROOKSIDE CARE STRATEGIES |
Practice Address |
505 North Gavin Street Muncie IN 47303 |
Mailing Address |
402 W Main St Greenwood IN 46142-3115 |
Practice Telephone | 7652891915 |
Practice Fax Number | 7652896435 |
Mailing Telephone | 5742009706 |
Enumeration Date | 2007-05-03 |
Last Update Date | 2019-01-03 |
Authorized Official Name | GREGG MALOTT (DIRECTOR OF BUSINESS DEVELOPMENT) |
Authorized Official Telephone | 5749462103 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 07-000311-1 | IN | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 100285520 | 05 |
Other Name | Type Code |
---|---|
Brookside Care Strategies | Doing Business As Name - Organization |
Brookside Haven Health Care Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336548353 | Pulaski Memorial Hospital | Skilled Nursing Facility | 6050 S Cr 800 E-92, Fort Wayne, IN 46814-9201 | 2014-08-14 |
1801205240 | Pulaski Memorial Hospital | Assisted Living Facility | 5250 Heritage Pkwy, Fort Wayne, IN 46835-1061 | 2014-08-11 |
1346263217 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 700 E 21st Ave, Gary, IN 46407 | 2006-07-25 |
1710930524 | Pulaski Memorial Hospital | Skilled Nursing Facility | 624 E 13th St, Winamac, IN 46996-1117 | 2006-05-19 |
1306837869 | Pulaski Memorial Hospital | Skilled Nursing Facility | 516 Williams St, Angola, IN 46703-1144 | 2005-11-03 |
1811987894 | Pulaski Memorial Hospital | Skilled Nursing Facility | 643 West Utica Street, Sellersburg, IN 47172-1163 | 2005-10-21 |
1932196177 | Pulaski Memorial Hospital | Skilled Nursing Facility | 1010 W Washington Center Rd, Ft Wayne, IN 46825-4155 | 2005-10-03 |
1376540310 | Pulaski Memorial Hospital | Home Health | 616 E. 13th Street, Winamac, IN 46996-1117 | 2005-07-06 |
1346245271 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 801 Huntington Ave, Warren, IN 46792-9402 | 2005-06-16 |
1477556546 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 1180 W 500 N, Huntington, IN 46750-1661 | 2005-05-23 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | PULASKI MEMORIAL HOSPITAL | 616 E 13th St, Winamac, IN 46996-1117 |
Street Address |
505 NORTH GAVIN STREET |
City | MUNCIE |
State | IN |
Zip Code | 47303 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144790726 | Elisabeth Marriah Bernal | Nurse Practitioner | 2525 W University Ave Suite 300, Muncie, IN 47303 | 2018-11-27 |
1013413806 | Charles Austin Curtis | Student in an Organized Health Care Education/Training Program | Iu Health Ball Memorial Family Medicine Residency, 221 North Celia Avenue, Muncie, IN 47303 | 2018-04-02 |
1730607359 | Ronald Settles | Home Health | 1812 Carver Dr, Muncie, IN 47303 | 2017-09-04 |
1932635034 | Abigail Chilsen | Student in an Organized Health Care Education/Training Program | 221 North Celia Avenue, Iu Health Ball Memorial Family Medicine Residency, Muncie, IN 47303 | 2017-05-10 |
1780117176 | Adil Khan | Internal Medicine | Iu Health Ball Memorial Hospital, 2525 W. University Ave, Suite 401, Muncie, IN 47303 | 2017-04-04 |
1508212044 | Erick Reece Christensen | Student in an Organized Health Care Education/Training Program | 2525 W University Ave Iu Health Ball Memorial Hospital, Suite 401, Muncie, IN 47303 | 2016-05-13 |
1700230075 | Mallory Nebergall | Student in an Organized Health Care Education/Training Program | 2525 W. University Ave. Ste 401, Iu Health Ball Memorial Hospital, Muncie, IN 47303 | 2016-04-22 |
1811341282 | Padmini Parameswaran | Student in an Organized Health Care Education/Training Program | 2525 W. University Ave, Suite 401, Muncie, IN 47303 | 2016-04-21 |
1437557345 | Great Lakes Family Dental Group-muncie, P.C. | Dentist | 1003 W. Mcgalliard Road, Muncie, IN 47303 | 2014-12-09 |
1194145185 | Swetha Boddeda | Student in an Organized Health Care Education/Training Program | 2401 W University Lane, Iu Health Ball Memorial Hospital, Muncie, IN 47303 | 2014-04-17 |
Find all providers in zip 47303 |
Taxonomy Code | 313M00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Nursing Facility/Intermediate Care Facility |
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871040659 | Stephanie Hentrup | Nursing Facility/Intermediate Care Facility | 621 E 20th St, Ferdinand, IN 47532-9220 | 2016-09-08 |
1912354630 | Denise Chambery | Nursing Facility/Intermediate Care Facility | 5707 W 122nd Pl, Crown Point, IN 46307-8778 | 2016-05-23 |
1124494760 | Maplemanor Christian Home, Inc. | Nursing Facility/Intermediate Care Facility | 643 W Utica St, Sellersburg, IN 47172-1163 | 2015-08-18 |
1174868822 | Daviess County Hospital | Nursing Facility/Intermediate Care Facility | 120 East Miller Drive, Bloomington, IN 47407-6538 | 2012-12-06 |
1134493281 | Adams County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 9802 Coldwater Road, Fort Wayne, IN 46825 | 2012-03-06 |
1447481049 | Larry Wayne Sims | Nursing Facility/Intermediate Care Facility | 1236 Lincoln Ave, Evansville, IN 47714-1056 | 2009-07-30 |
1720253313 | Davis Elderly Care, LLC | Nursing Facility/Intermediate Care Facility | 5139 S Hanover Saluda Rd, Hanover, IN 47243-9212 | 2008-04-24 |
1750585766 | Gosport Care, Inc. | Nursing Facility/Intermediate Care Facility | 27 S. 7th St., Gosport, IN 47433-0099 | 2007-06-13 |
1790986792 | Evansville Protestant Home Inc. | Nursing Facility/Intermediate Care Facility | 3701 Washington Ave, Evansville, IN 47714-0544 | 2007-05-29 |
1982729604 | Adams County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 6996 S Us 421, Versailles, IN 47042-9390 | 2007-03-20 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.