Provider Demographics
NPI:1235739764
Name:PINNACLE FAMILY HEALTH CARE
Entity Type:Organization
Organization Name:PINNACLE FAMILY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SASIPHA
Authorized Official - Middle Name:N
Authorized Official - Last Name:PAHAMARK
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP
Authorized Official - Phone:405-570-0235
Mailing Address - Street 1:2781 WASHINGTON DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069
Mailing Address - Country:US
Mailing Address - Phone:405-570-0235
Mailing Address - Fax:
Practice Address - Street 1:2781 WASHINGTON DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069
Practice Address - Country:US
Practice Address - Phone:405-570-0235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty