Healthcare Provider Details

I. General information

NPI: 1306104047
Provider Name (Legal Business Name): PINNACLE HEALTH MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21992 MAIN ST SUITE 2
HYDEN KY
41749-8567
US

IV. Provider business mailing address

PO BOX 600
HAZARD KY
41702-0600
US

V. Phone/Fax

Practice location:
  • Phone: 606-672-4800
  • Fax: 606-436-5282
Mailing address:
  • Phone: 606-435-7642
  • Fax: 606-436-5282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MRS. TONYA MARTIN
Title or Position: MEMBER
Credential:
Phone: 606-439-1300