Healthcare Provider Details
I. General information
NPI: 1134790645
Provider Name (Legal Business Name): PINNACLE HEALTH MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2021
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
441 E CHOCOLATE AVE
HERSHEY PA
17033-1324
US
IV. Provider business mailing address
409 S 2ND ST STE 2F
HARRISBURG PA
17104-1612
US
V. Phone/Fax
- Phone: 717-533-7850
- Fax: 717-533-8294
- Phone: 717-231-8038
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMY
F
WILKINSON
Title or Position: PE MANAGER
Credential:
Phone: 717-231-8038