MEDICARE: PINNACLE ALLIANCE HOME HEALTH CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	APPLIED FOR

General Provider Information

NPI Number	:	1063716199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE ALLIANCE HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	9889 GATE PKWY N
Second Line	:	UNIT 301
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-9228
Country	:	US
Telephone Number	:	904-652-2651
Fax Number	:	904-652-2653

Provider Business Practice Location Address
First Line	:	9889 GATE PKWY N
Second Line	:	UNIT 301
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-9228
Country	:	US
Telephone Number	:	904-652-2651
Fax Number	:	904-652-2653

Authorized Official
Title or Position	:	OWNER
Name	:	JEAN CORBO
Credential	:
Telephone Number	:	904-652-2651

Provider Enumeration Date	:	01/04/2011
Last Update Date	:	01/04/2011

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