MEDICARE: PINNACLE HEALTHCARE SOLUTIONS, 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	207Q00000X	Family Medicine Physician	22198	OK

General Provider Information

NPI Number	:	1891094710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE HEALTHCARE SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	17565 REDBUD LN
Second Line	:
City	:	MORRIS
State	:	OK
Zip	:	74445-2354
Country	:	US
Telephone Number	:	918-978-9177
Fax Number	:

Provider Business Practice Location Address
First Line	:	17565 REDBUD LN
Second Line	:
City	:	MORRIS
State	:	OK
Zip	:	74445-2354
Country	:	US
Telephone Number	:	918-978-9177
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ZACHARIAH ANDERSON
Credential	:	M.D.
Telephone Number	:	918-978-9177

Provider Enumeration Date	:	03/17/2011
Last Update Date	:	03/18/2011

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