Healthcare Provider Details
I. General information
NPI: 1811407679
Provider Name (Legal Business Name): PINNACLE HEALTH MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2017
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4300 LONDONDERRY RD STE 305
HARRISBURG PA
17109-5317
US
IV. Provider business mailing address
409 S 2ND ST STE 2F
HARRISBURG PA
17104-1612
US
V. Phone/Fax
- Phone: 717-791-2960
- Fax: 717-791-2961
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0000X |
| Taxonomy | Obstetrics Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VF0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
P
MARKLEY
Title or Position: SENIOR VP
Credential:
Phone: 717-231-8210