Healthcare Provider Details

I. General information

NPI: 1376011429
Provider Name (Legal Business Name): PINNACLE HEALTH MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 HARRISBURG ST
EAST BERLIN PA
17316-9505
US

IV. Provider business mailing address

409 S 2ND ST STE 2F
HARRISBURG PA
17104-1612
US

V. Phone/Fax

Practice location:
  • Phone: 717-259-0222
  • Fax: 717-259-6348
Mailing address:
  • Phone: 717-231-8929
  • Fax: 717-221-5673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER P MARKLEY
Title or Position: SENIOR VP
Credential:
Phone: 717-231-8210