PULASKI MEMORIAL HOSPITAL (NPI# 1801205240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801205240 |
| Entity Type | Organization |
| Organization Name | PULASKI MEMORIAL HOSPITAL |
| Other Organization Name | THE HERITAGE OF FORT WAYNE |
| Practice Address |
5250 Heritage Pkwy Fort Wayne IN 46835-1061 |
| Mailing Address |
616 E 13th St Winamac IN 46996-1117 |
| Practice Telephone | 2602096279 |
| Practice Fax Number | 2602066284 |
| Mailing Telephone | 5749462103 |
| Mailing Fax Number | 5749462129 |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2019-04-18 |
| Authorized Official Name | GREGG MALOTT (DIRECTOR OF BUSIENSS DEVELOPMENT) |
| Authorized Official Telephone | 5749462103 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | 15-012931-1 | IN | Nursing & Custodial Care Facilities |
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | 15-012931-1 | IN | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 15-012931-1 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201278730A | 05 |
| Other Name | Type Code |
|---|---|
| The Heritage of Fort Wayne | 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 |
| 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 |
| 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 |
5250 HERITAGE PKWY |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46835-1061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093320384 | Emily Bussick | Speech-Language Pathologist | 5250 Heritage Pkwy, Fort Wayne, IN 46835-1061 | 2020-09-13 |
| 1942762562 | Vanessa P Lewis | Speech-Language Pathologist | 5250 Heritage Pkwy, Fort Wayne, IN 46835-1061 | 2019-04-02 |
| 1619449865 | Jenika Shah | Physical Therapist | 5250 Heritage Pkwy, Fort Wayne, IN 46835-1061 | 2018-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760993810 | Longe Enterprises Corp | Eyewear Supplier (Equipment, not the service) | 5711 Ymca Park Dr East, Fort Wayne, IN 46835 | 2017-10-17 |
| 1801144464 | Tracey Gordon | Physical Therapy Assistant | 2827 Northgate Boulevard, Fort Wayne, IN 46835 | 2012-08-29 |
| 1316179682 | Janet L Daniel | Counselor | 310 E Dupont Road, Suite 2, Fort Wayne, IN 46835 | 2009-08-20 |
| 1083868863 | Nicholas Joseph Sullivan | Chiropractor | 8320 Chapel Bend Drive, Fort Wayne, IN 46835 | 2008-11-06 |
| 1497922090 | Michelle A Bailey | Registered Nurse | 6108 Maplecrest Road, Fort Wayne, IN 46835 | 2008-05-13 |
| 1073789954 | Charles Arthur Bolinger | Technician, Other | 4546 Maplecrest Rd, Ft Wayne, IN 46835 | 2008-05-01 |
| 1851469878 | Richard J Klaehn | Optometrist | 4536 Maplecrest Road, Ft. Wayne, IN 46835 | 2006-11-30 |
| 1639272339 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 6220 St Joseph Center Rd, Fort Wayne, IN 46835 | 2006-09-07 |
| 1275649014 | Adrienne Meyer | Pharmacist | 7909 Brixham Place, Fort Wayne, IN 46835 | 2006-08-22 |
| 1750378147 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 4430 Elsdale Dr, Fort Wayne, IN 46835 | 2005-09-30 |
| Find all providers in zip 46835 | ||||
| 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 |
|---|---|---|---|---|
| 1023487592 | Lindsey Marie Fuller | Skilled Nursing Facility | 10603 Wild Flower Pl, Fort Wayne, IN 46845-1687 | 2015-09-15 |
| 1336548353 | Pulaski Memorial Hospital | Skilled Nursing Facility | 6050 S Cr 800 E-92, Fort Wayne, IN 46814-9201 | 2014-08-14 |
| 1154766459 | Major Hospital | Skilled Nursing Facility | 10445 Dupont Oaks Blvd, Fort Wayne, IN 46845-8792 | 2013-05-01 |
| 1326310400 | Riverview Hospital | Skilled Nursing Facility | 4111 Park Place Drive, Fort Wayne, IN 46845-8793 | 2012-02-03 |
| 1710280888 | Kelly Michelle Wood | Skilled Nursing Facility | 8528 Killeen Run, Fort Wayne, IN 46835-9657 | 2010-12-13 |
| 1194940205 | Recovery Health Services, Inc | Skilled Nursing Facility | 12101 Lima Rd, Fort Wayne, IN 46818-8903 | 2007-04-16 |
| 1871623041 | Henry County Memorial Hospital | Skilled Nursing Facility | 1400 Medical Park Dr, Fort Wayne, IN 46825-5832 | 2007-03-06 |
| 1740315878 | Henry County Memorial Hospital | Skilled Nursing Facility | 5700 Wilkie Dr, Fort Wayne, IN 46804-1662 | 2007-02-22 |
| 1326180803 | Woodlawn Hospital | Skilled Nursing Facility | 3136 Goeglein Rd, Fort Wayne, IN 46815-6685 | 2007-02-13 |
| 1528130432 | Indiana Health & Rehabilitation Center | Skilled Nursing Facility | 3811 Parnell Ave, Fort Wayne, IN 46805-1409 | 2006-11-15 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46835 |
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.