Provider Demographics
NPI:1013588581
Name:PINNACLE MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:PINNACLE MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MAOBUGHICHI
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:720-215-6701
Mailing Address - Street 1:14261 E 4TH AVE STE 285
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8446
Mailing Address - Country:US
Mailing Address - Phone:720-532-8130
Mailing Address - Fax:866-410-3231
Practice Address - Street 1:14261 E 4TH AVE STE 285
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8446
Practice Address - Country:US
Practice Address - Phone:720-532-8130
Practice Address - Fax:866-410-3231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20211626695OtherCOLORADO SECRETARY OF STATE