PULASKI MEMORIAL HOSPITAL NPI 1831679620

NPI Information

NPI: 1831679620
Provider Name: PULASKI MEMORIAL HOSPITAL
Classification: Clinic/Center - 261QR1300X
Specialization: Rural Health
Entity Type: Organization
Doing Business As: PULASKI MEMORIAL HOSPITAL NORTH JUDSON FAMILY MEDICINE
CLIA Number: 15D2137056
Address: 414 LANE ST
NORTH JUDSON, IN
ZIP 46366
Phone: (574) 896-4325

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NPI Details

PULASKI MEMORIAL HOSPITAL is a rural health clinic center in North Judson, IN. PULASKI MEMORIAL HOSPITAL NPI is 1831679620. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Pulaski Memorial Hospital North Judson Family Medicine.

The provider's business location address is:

414 LANE ST
NORTH JUDSON, IN
ZIP 46366-226
Phone: (574) 896-4325

The provider's authorized official is Gregg Malott .
The authorized official title is Cfo and has the following contact phone number (574) 946-2103.

The CLIA number assigned to this NPI record is 15D2137056 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/21/2018 and was last updated on 10/11/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				No
2	261QR1300X	Clinic/Center	Rural Health			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	300014361	MEDICAID	INDIANA

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: 11/21/2025

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