Healthcare Provider Details
I. General information
NPI: 1003346230
Provider Name (Legal Business Name): PINNACLE HEALTH REGIONAL PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2017
Last Update Date: 06/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
80 DOE RUN RD
MANHEIM PA
17545-9314
US
IV. Provider business mailing address
409 S 2ND ST STE 2F
HARRISBURG PA
17104-1612
US
V. Phone/Fax
- Phone: 717-664-0952
- Fax: 717-664-0955
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
CHRISTOPHER
P.
MARKLEY
Title or Position: SR VP, STRAT SVCS/GEN COUNSEL
Credential:
Phone: 717-231-8210