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CAH151305-00 PULASKI MEMORIAL HOSPITAL (Active)
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Main Details
Name
PULASKI MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH151305-00
Medicare Provider Number
151305
Additional Details
Current Program Status
Active
Registration Date
8/9/2010
Participating Start Date
8/9/2010
Participating Approval Date
8/9/2010
Last Recertification Date
8/29/2024
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
616 E. 13TH STREET
WINAMAC, IN 46996
Billing Address
PULASKI MEMORIAL HOSPITAL
PO BOX 279
WINAMAC, IN 46996
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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