MEDICARE: PINNACLE 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	261QS1200X	Sleep Disorder Diagnostic Clinic/Center	MD00033867	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00217647	OTHER	WA	MEDICARE RAILROAD NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	9056631	OTHER	WA	DME SUPPLIER FOR DSHS
3	1116938	OTHER	WA	DSHS
4	607333500	OTHER	WA	OFFICE OF WORKERS COMP

General Provider Information

NPI Number	:	1649271552
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	1460 N 16TH AVE
Second Line	:	STE. B
City	:	YAKIMA
State	:	WA
Zip	:	98902-7102
Country	:	US
Telephone Number	:	509-248-0497
Fax Number	:	509-248-4167

Provider Business Practice Location Address
First Line	:	1460 N 16TH AVE
Second Line	:	STE. B
City	:	YAKIMA
State	:	WA
Zip	:	98902-7102
Country	:	US
Telephone Number	:	509-248-0497
Fax Number	:	509-248-4167

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ABHIJIT G DESHPANDE
Credential	:	M.D
Telephone Number	:	509-248-0497

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	09/08/2009

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Directions to “PINNACLE HEALTH CARE LLC ” Practice Location

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