PULASKI MEMORIAL HOSPITAL (NPI# 1194167650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194167650 |
| Entity Type | Organization |
| Organization Name | PULASKI MEMORIAL HOSPITAL |
| Other Organization Name | THE MILTON HOME |
| Practice Address |
206 E Marion St South Bend IN 46601-1029 |
| Practice Telephone | 5742330165 |
| Practice Fax Number | 5742379818 |
| Mailing Telephone | 5742330165 |
| Mailing Fax Number | 5742379818 |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2018-03-21 |
| Authorized Official Name | PHILIP MONROE MEYER (MANAGER) |
| Authorized Official Telephone | 4238341494 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 12-001141-1 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE PROVIDER NUMBER | 155738 | 01 |
| Other Name | Type Code |
|---|---|
| The Milton Home | 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 |
| 1881816148 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 505 North Gavin Street, Muncie, IN 47303 | 2007-05-03 |
| 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 |
| 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 |
206 E MARION ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601-1029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235219148 | Janeczko Properties LLC | Skilled Nursing Facility | 206 E Marion St, South Bend, IN 46601-1029 | 2006-10-16 |
| 1902417637 | Stacey Rae Croson | Occupational Therapist | 206 E Marion St, South Bend, IN 46601-1029 | 2020-08-14 |
| 1811478050 | Nicole Simeri | Speech-Language Pathologist | 206 E Marion St, South Bend, IN 46601-1029 | 2018-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447610449 | David Thomas | Hearing Instrument Specialist | 808 S Michigan St., South Bend, IN 46601 | 2016-03-03 |
| 1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
| 1952605560 | Robert Lusk Bonham | Dentist | 1222 L.w.e., So. Bend, IN 46601 | 2010-12-23 |
| 1649580911 | Daniel Scott Debrule | Psychologist | 211 W. Washington Street, Suite 2311, South Bend, IN 46601 | 2010-10-20 |
| 1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
| 1548497837 | Tmg Home Health Care | Home Health | 108 N Main St #305, South Bend, IN 46601 | 2009-06-15 |
| 1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
| 1740432574 | Amanda Jayne Quicksall | Social Worker | 611 Lincolnway W, South Bend, IN 46601 | 2008-10-10 |
| 1952565772 | Thomas P Judd | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46601 | 2008-07-10 |
| 1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
| Find all providers in zip 46601 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821427857 | Hancock Regional Hospital | Skilled Nursing Facility | 52565 Sr 933, South Bend, IN 46637 | 2013-11-12 |
| 1295064525 | Starlight Care Facilities, Inc | Skilled Nursing Facility | 915 So. 27th Street, South Bend, IN 46615 | 2009-12-16 |
| 1669544516 | Indiana Health and Rehabilitation Centers | Skilled Nursing Facility | 1950 Ridgedale Rd, South Bend, IN 46614-2243 | 2006-11-15 |
| 1871674556 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 4600 W Washington St, South Bend, IN 46619 | 2006-10-18 |
| 1235219148 | Janeczko Properties LLC | Skilled Nursing Facility | 206 E Marion St, South Bend, IN 46601-1029 | 2006-10-16 |
| 1821185356 | Adams County Memorial Hospital | Skilled Nursing Facility | 17475 Dugdale Dr, South Bend, IN 46635-1545 | 2006-10-06 |
| 1093750119 | St. Clair Darden Health System Inc | Skilled Nursing Facility | 20531 Darden Rd, South Bend, IN 46637-2915 | 2006-06-20 |
| 1841287232 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1121 E Lasalle Ave, South Bend, IN 46617 | 2005-09-30 |
| 1477913754 | Chalet of Hastings LLC | Skilled Nursing Facility | 6101 Nimtz Pkwy, South Bend, IN 46628-6111 | 2016-03-01 |
| 1487044822 | Decatur County Memorial Hospital | Skilled Nursing Facility | 5024 W Western Ave, South Bend, IN 46619-2312 | 2015-01-23 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
Please comment or provide details below to improve the information on PULASKI MEMORIAL HOSPITAL.
| 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.