Provider Demographics
NPI:1346911104
Name:PINNACLE DERMATOLOGY, SC
Entity Type:Organization
Organization Name:PINNACLE DERMATOLOGY, SC
Other - Org Name:PINNACLE DERMATOLOGY, FREDERICKSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:LAPINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-744-8554
Mailing Address - Street 1:5141 VIRGINIA WAY STE 350
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1985 EMANCIPATION HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-6233
Practice Address - Country:US
Practice Address - Phone:540-373-6647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINNACLE DERMATOLOGY, SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-22
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site