Provider Demographics
NPI:1386683324
Name:PINNACLE HEALTHCARE MANAGEMENT, INC.
Entity Type:Organization
Organization Name:PINNACLE HEALTHCARE MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-691-9915
Mailing Address - Street 1:44 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-4851
Mailing Address - Country:US
Mailing Address - Phone:856-691-9915
Mailing Address - Fax:856-691-5241
Practice Address - Street 1:44 S STATE ST
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4851
Practice Address - Country:US
Practice Address - Phone:856-691-9915
Practice Address - Fax:856-691-5241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092330Medicare ID - Type Unspecified