NPIMap

Organization Active NPI

Pulaski Memorial Hospital

Doing business as Brookside Care Strategies

  • Nursing Facility/Intermediate Care Facility
  • Muncie, IN
National Provider Identifier
1881816148
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
07-000311-1 Issued in IN
Legal business name
PULASKI MEMORIAL HOSPITAL
Doing business as
Brookside Care Strategies
Practice address
505 North Gavin Street
Muncie, IN 47303
Phone
(765) 289-1915
Fax
(765) 289-6435
NPI assigned
May 3, 2007
Last updated
Jan 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Authorized official

Name
Gregg Malott
Title
Director of Business Development
Phone
(574) 946-2103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 07-000311-1 IN Primary

Addresses

Primary practice location

505 North Gavin Street
Muncie, IN 47303

Mailing address

402 W Main St
Greenwood, IN 46142-3115
Phone (574) 200-9706

Other identifiers 1

IdentifierTypeStateIssuer
100285520MedicaidIN

Other names 1

  • Brookside Care Strategies Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Michael D Ramone DO43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1881816148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W MAIN ST",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461423115",
            "telephone_number": "574-200-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NORTH GAVIN STREET",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47303",
            "telephone_number": "765-289-1915",
            "fax_number": "765-289-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULASKI MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "MALOTT",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "574-946-2103"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IN",
            "license": "07-000311-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100285520",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside Care Strategies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.