MEDICARE: PINNACLE MANAGEMENT, LLC

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	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1760616726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE MANAGEMENT, LLC

Provider Business Mailing Address
First Line	:	PO BOX 2045
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40476-2045
Country	:	US
Telephone Number	:	859-626-1504
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 ALYCIA DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2368
Country	:	US
Telephone Number	:	859-626-1504
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR/ RADIOLOGIST
Name	:	DR. TIMOTHY E DINEEN
Credential	:	MD
Telephone Number	:	859-626-1504

Provider Enumeration Date	:	05/06/2009
Last Update Date	:	09/23/2010

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