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General NPI Number Information
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NPI Number | 1548480601
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Entity Type | Organization
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Legal Business Name | PINNACLE REGIONAL HOSPITAL, LLC
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 17651 B HWY
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City | BOONVILLE
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State | MO
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Zip | 65233
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Country | US
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Telephone | 660-882-7461
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Fax | 660-882-6093
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Provider Business Mailing Address
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Address Line | 17651 B HWY
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City | BOONVILLE
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State | MO
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Zip | 65233-2839
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RHC MANAGER
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Name | JENNIFER SKANES
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Credential |
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Telephone | 660-882-7461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 24836
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 248-47
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License Number State | MO
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