Pulaski Memorial Hospital
Organization Active NPI Home Health Agency · Winamac, IN
NPI 1376540310 · NPPES record last updated Sep 7, 2022
Key facts
- NPI
- 1376540310
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 005285 (IN)
- Legal business name
- PULASKI MEMORIAL HOSPITAL
- Practice address
- 616 E. 13TH Street
Winamac, IN 46996-1117 - Phone
- (574) 946-2140
- Fax
- (574) 946-2128
- NPI assigned
- Jul 6, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- PULASKI MEMORIAL HOSPITAL
Authorized official
- Name
- Mrs. Vickie A White, RN
- Title
- Director
- Phone
- (574) 946-2146
Member of 1
Change of ownership 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jan 1, 2020 | Change of Ownership |
Community Home Care Services Inc |
National Provider Directory
- Part of
- Cindy Parker MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 005285 | IN | Yes |
| Critical Access Hospital | 282NC0060X |
Addresses
Primary practice location
616 E. 13TH Street
Winamac, IN 46996-1117
Mailing address
616 E. 13TH Street
PO Box 279
Winamac, IN 46996-1117
Phone (574) 946-2140
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100263320A | Medicaid | IN | |
| 005285 | Other | IN | STATE LICENSE NUMBER |
Other names
- Pulaski Memorial Home Health Care
- Pulaski Memorial Home Health Care and Hospice
Other providers in Winamac, IN
- Proactive Mso, LLC
- Pulaski County Auditor
- Pulaski County Health Department
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
All providers in Winamac, IN · Home Health Agency in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.