MEDICARE: PINNACLE DERMATOLOGY, S.C.

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	332900000X	Non-Pharmacy Dispensing Site

General Provider Information

NPI Number	:	1740112051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE DERMATOLOGY, S.C.

Provider Business Mailing Address
First Line	:	5141 VIRGINIA WAY STE 350
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-2319
Country	:	US
Telephone Number	:	615-457-8143
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 E IRONWOOD SQUARE DR STE 110
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4582
Country	:	US
Telephone Number	:	480-948-8400
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR SUPPLY CHAIN AND PHARMACY
Name	:	DANA CONNER
Credential	:
Telephone Number	:	615-457-8143

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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