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General NPI Number Information
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NPI Number | 1336538156
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Entity Type | Organization
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Legal Business Name | PINNACLE HEALTHCARE SERVICES INC
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Dates
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Enumeration Date | 01/16/2015
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Last Update Date | 07/06/2015
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Provider Practice Location Address
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Address Line | 183 PEATMOSS DR APT L
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-8970
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Country | US
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Telephone | 910-728-6019
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Fax | 919-872-7450
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Provider Business Mailing Address
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Address Line | 183 PEATMOSS DR APT L
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-8970
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Country | US
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Telephone | 910-728-6019
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Fax | 919-872-7450
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Authorized Official
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Title or Position | OWNER
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Name | OBBY A IKE
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Credential | RN
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Telephone | 910-728-6019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HC2523
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | FCL032143
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License Number State | NC
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