Provider Demographics
NPI:1104878974
Name:PINNACLE HEALTH MEDICAL & SURGICAL ASSOCIATES
Entity type:Organization
Organization Name:PINNACLE HEALTH MEDICAL & SURGICAL ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:P
Authorized Official - Last Name:MARKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-231-8210
Mailing Address - Street 1:409 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:717-231-8200
Mailing Address - Fax:717-231-8964
Practice Address - Street 1:810 SIR THOMAS CT
Practice Address - Street 2:SUITE 101
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4839
Practice Address - Country:US
Practice Address - Phone:717-614-4420
Practice Address - Fax:717-231-8964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100766676Medicaid
PA100766676Medicaid