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CAH151305-05 PULASKI MEMORIAL HOSPITAL (Approved)
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Main Details
Name
PULASKI MEMORIAL HOSPITAL
Subdivision Name
PULASKI MEMORIAL HOSPITAL - General Healthcare
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH151305-05
Medicare Provider Number
151305
Outpatient Facility Provider Number
158581
Additional Details
Current Program Status
Approved
Registration Date
4/7/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/14/2025
Last Recertification Date
Contacts
Authorizing Official
Pulaski Memorial Hospital
GREGG Alan MALOTT, DIRECTOR OF BUSINESS DEVELOPMENT
(574) 946-2103
Primary Contact
Pulaski Memorial Hospital
Michelle Thomas, Director of Pharmacy
(574) 946-2185
Addresses
Street Address
232 S MAIN ST STE A
CULVER MEDICAL CENTER
CULVER, IN 46511-1648
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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