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General NPI Number Information
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NPI Number | 1225243389
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Entity Type | Organization
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Legal Business Name | PINNACLE EASYCARE LLC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7231 S EASTERN AVE B243
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City | LAS VEGAS
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State | NV
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Zip | 89119-0451
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Country | US
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Telephone | 888-932-8550
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Fax | 702-932-8587
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Provider Business Mailing Address
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Address Line | 7231 S EASTERN AVE B243
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City | LAS VEGAS
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State | NV
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Zip | 89119-0451
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Country | US
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Telephone | 888-932-8550
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Fax | 702-932-8587
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MALISSA THATCHER
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Credential |
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Telephone | 702-932-8547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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