- Enrollment id
- O20260331000430
- Enrollment state
- IN
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1053358960
- Multiple npi flag
- N
- Ccn
- 155491
- Associate id
- 3173515509
- Organization name
- PULASKI MEMORIAL HOSPITAL
- Doing business as name
- MAJESTIC CARE OF CONNERSVILLE
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Nursing home provider name
- MAJESTIC CARE OF CONNERSVILLE
- Affiliation entity name
- MAJESTIC CARE
- Affiliation entity id
- 331
- Address line 1
- 1029 E 5TH ST
- City
- CONNERSVILLE
- State
- IN
- Zip code
- 473313301