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PULASKI MEMORIAL HOSPITAL NPI 1346263217


NPI Information

NPI: 1346263217
Provider Name: PULASKI MEMORIAL HOSPITAL

Doing Business As: SIMMONS LOVING CARE HEALTH FACILITY

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization

CLIA Number: 15D0875920

Address:
700 E 21ST AVE
GARY, IN
ZIP 46407
Phone: (219) 882-2563
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PULASKI MEMORIAL HOSPITAL is a nursing facility intermediate care facility in Gary, IN. The provider is 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. PULASKI MEMORIAL HOSPITAL NPI is 1346263217. The provider is registered as an organization entity type.
The provider Is Doing Business As Simmons Loving Care Health Facility.

The provider's business location address is:

700 E 21ST AVE
GARY, IN
ZIP 46407
Phone: (219) 882-2563
Fax: (219) 882-2616

The provider's authorized official is Gregg A Malott .
The authorized official title is Dir. Of Business Development and has the following contact phone number (574) 946-2100.

The CLIA number assigned to this NPI record is 15D0875920 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 9/26/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1313M00000XNursing Facility/Intermediate Care Facility05-000368-1INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100275220AMEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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