NPIMap

Organization Active NPI

Pulaski Community Hospital Inc

Doing business as Lewisgale Hospital Pulaski

  • Electrodiagnostic Medicine Physician
  • Pulaski, VA
National Provider Identifier
1508805540
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X
Legal business name
PULASKI COMMUNITY HOSPITAL INC
Doing business as
Lewisgale Hospital Pulaski
Practice address
2400 Lee Hwy N
Pulaski, VA 24301-2326
Phone
(540) 994-8100
Fax
(540) 994-8333
NPI assigned
Jun 5, 2006
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PULASKI COMMUNITY HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy W. Haasken
Title
Cfo
Phone
(540) 994-8311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electrodiagnostic Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204R00000X Primary

Addresses

Primary practice location

2400 Lee Hwy N
Pulaski, VA 24301-2326

Mailing address

PO Box 759
Pulaski, VA 24301-0759
Phone (540) 994-8100

Other names 1

  • LEWISGALE HOSPITAL PULASKI Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031113000192 VA Part B Supplier - Clinic/Group Practice 4688588841 Receives reassigned benefits from 3 practitioners
Practice locations: Pulaski, VA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
All Care Home HLTH Serv

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

327 N Washington Ave
Pulaski, VA 24301
Phone (540) 994-5023

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1508805540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 759",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243010759",
            "telephone_number": "540-994-8100",
            "fax_number": "540-994-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LEE HWY N",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243012326",
            "telephone_number": "540-994-8100",
            "fax_number": "540-994-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULASKI COMMUNITY HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PULASKI COMMUNITY HOSPITAL INC",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "HAASKEN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "540-994-8311"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEWISGALE HOSPITAL PULASKI",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LEWISGALE HOSPITAL PULASKI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pulaski, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.