Healthcare Provider Details

I. General information

NPI: 1518272764
Provider Name (Legal Business Name): PINNACLE HEALTH MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8105 ADAMS DR SUITE A
HUMMELSTOWN PA
17036-8625
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 717-652-1211
  • Fax: 717-652-4948
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1007666760064
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MR. PHILIP W GUARNESCHELLI
Title or Position: SENIOR VP-CHIEF OPERATING OFFICER
Credential:
Phone: 717-231-8200