Provider Demographics
NPI:1306104047
Name:PINNACLE HEALTH MANAGEMENT, LLC
Entity type:Organization
Organization Name:PINNACLE HEALTH MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-439-1300
Mailing Address - Street 1:PO BOX 600
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41702-0600
Mailing Address - Country:US
Mailing Address - Phone:606-435-7642
Mailing Address - Fax:606-436-5282
Practice Address - Street 1:21992 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HYDEN
Practice Address - State:KY
Practice Address - Zip Code:41749-8567
Practice Address - Country:US
Practice Address - Phone:606-672-4800
Practice Address - Fax:606-436-5282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY620662500OtherUS DEPARTMENT OF LABOR
KY7100239760Medicaid
KY620662500OtherUS DEPARTMENT OF LABOR