Healthcare Provider Details
I. General information
NPI: 1255861118
Provider Name (Legal Business Name): PINNACLE HEALTH MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/14/2017
Last Update Date: 06/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 S 17TH ST
HARRISBURG PA
17104-1123
US
IV. Provider business mailing address
409 S 2ND ST STE 2F
HARRISBURG PA
17104-1612
US
V. Phone/Fax
- Phone: 717-232-9971
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0206X |
| Taxonomy | Mammography Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
P
MARKLEY
Title or Position: SENIOR VP
Credential:
Phone: 717-231-8210