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NPI Code Detail

MEDICARE: PINNACLE HEALTH FACILITIES XVII LP

MEDICARE: PINNACLE HEALTH FACILITIES XVII LP
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
1314000000XSkilled Nursing FacilityIA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356425698
Entity Type Code : Organization
Provider Name (Legal Business Name) : PINNACLE HEALTH FACILITIES XVII LP
Provider Business Mailing Address
First Line : 5420 W PLANO PKWY
Second Line :
City : PLANO
State : TX
Zip : 75093-4823
Country : US
Telephone Number : 972-931-3800
Fax Number : 972-767-6222
Provider Business Practice Location Address
First Line : 1002 W WASHINGTON AVE
Second Line :
City : POLK CITY
State : IA
Zip : 50226-2132
Country : US
Telephone Number : 515-984-6411
Fax Number : 515-984-9294
Authorized Official
Title or Position : DIRECTOR OF REIMBURSEMENT
Name : MRS. JAMIE LATTURE COLLIER
Credential :
Telephone Number : 972-931-3800
Provider Enumeration Date : 10/24/2006
Last Update Date : 08/04/2011

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