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General NPI Number Information
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NPI Number | 1659604817
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Entity Type | Organization
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Legal Business Name | PINNACLE DIAGNOSTIC SERVICES LLC
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Dates
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Enumeration Date | 09/04/2009
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 72108 RAMOS AVE SUITE B
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City | COVINGTON
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State | LA
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Zip | 70433-9501
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Country | US
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Telephone | 972-834-6759
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Fax | 985-590-5223
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Provider Business Mailing Address
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Address Line | 72108 RAMOS AVE SUITE B
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City | COVINGTON
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State | LA
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Zip | 70433-9501
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Country | US
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Telephone | 972-834-6759
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Fax | 985-590-5223
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL GERHOLD
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Credential | RT
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Telephone | 972-834-6759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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