Provider Demographics
NPI: | 1598429367 |
---|---|
Name: | PINNACLE HEALTH MEDICAL SERVICES |
Entity type: | Organization |
Organization Name: | PINNACLE HEALTH MEDICAL SERVICES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PE MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | AMY |
Authorized Official - Middle Name: | F |
Authorized Official - Last Name: | WILKINSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 717-231-8038 |
Mailing Address - Street 1: | 409 S 2ND ST STE 2F |
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: | 717-231-8049 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2501 N 3RD ST FL 2 |
Practice Address - Street 2: | |
Practice Address - City: | HARRISBURG |
Practice Address - State: | PA |
Practice Address - Zip Code: | 17110-1904 |
Practice Address - Country: | US |
Practice Address - Phone: | 717-782-2852 |
Practice Address - Fax: | 717-782-5671 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-10-27 |
Last Update Date: | 2021-10-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 122300000X | Dental Providers | Dentist | Group - Multi-Specialty | |
No | 1223G0001X | Dental Providers | Dentist | General Practice | Group - Multi-Specialty |