MEDICARE: PINNACLE SURGERY CENTER

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1255911970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE SURGERY CENTER

Provider Business Mailing Address
First Line	:	1234 PINNACLE PKWY
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70433-9165
Country	:	US
Telephone Number	:	985-200-1213
Fax Number	:

Provider Business Practice Location Address
First Line	:	1234 PINNACLE PKWY
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70433-9165
Country	:	US
Telephone Number	:	985-200-1213
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. STEPHANIE CHAUVIN DANIELSON
Credential	:	RN
Telephone Number	:	985-200-1213

Provider Enumeration Date	:	04/08/2021
Last Update Date	:	04/08/2021

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Directions to “PINNACLE SURGERY CENTER ” Practice Location

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