MEDICARE: PINNACLE ENTERPRISES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist
2	207L00000X	Anesthesiology Physician	26975	AL
3	207Q00000X	Family Medicine Physician	7157	AL
4	208000000X	Pediatrics Physician	26862	AL
5	332B00000X	Durable Medical Equipment & Medical Supplies
6	208D00000X	General Practice Physician	7157	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447374640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE ENTERPRISES PC

Provider Business Mailing Address
First Line	:	3700 S RAILROAD ST STE A
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-2994
Country	:	US
Telephone Number	:	334-664-0463
Fax Number	:	334-664-0466

Provider Business Practice Location Address
First Line	:	3700 S RAILROAD ST STE A
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-2994
Country	:	US
Telephone Number	:	334-664-0463
Fax Number	:	334-664-0466

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. RITU CHANDRA
Credential	:	M.D.
Telephone Number	:	334-664-0463

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	07/21/2022

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Directions to “PINNACLE ENTERPRISES PC ” Practice Location

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