Healthcare Provider Details

I. General information

NPI: 1598952418
Provider Name (Legal Business Name): PINNACLE HEALTH FACILITIES XXIV LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 07/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 JENKS AVE
PANAMA CITY FL
32405-4530
US

IV. Provider business mailing address

5420 W PLANO PKWY
PLANO TX
75093-4823
US

V. Phone/Fax

Practice location:
  • Phone: 850-763-0446
  • Fax: 850-763-7787
Mailing address:
  • Phone: 972-931-3800
  • Fax: 972-930-8191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. JAMIE L COLLIER
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 972-930-8122