Provider Demographics
NPI:1225243389
Name:PINNACLE EASYCARE LLC
Entity Type:Organization
Organization Name:PINNACLE EASYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MALISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:THATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-932-8547
Mailing Address - Street 1:7231 S EASTERN AVE
Mailing Address - Street 2:B243
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0451
Mailing Address - Country:US
Mailing Address - Phone:888-932-8550
Mailing Address - Fax:702-932-8587
Practice Address - Street 1:7231 S EASTERN AVE
Practice Address - Street 2:B243
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0451
Practice Address - Country:US
Practice Address - Phone:888-932-8550
Practice Address - Fax:702-932-8587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty