Provider Demographics
NPI:1386847127
Name:PINNACLE FAMILY CARE PC
Entity Type:Organization
Organization Name:PINNACLE FAMILY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:MEACHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-476-9200
Mailing Address - Street 1:5495 S 500 E
Mailing Address - Street 2:STE 100
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-6923
Mailing Address - Country:US
Mailing Address - Phone:801-475-7100
Mailing Address - Fax:801-475-7101
Practice Address - Street 1:5495 S 500 E
Practice Address - Street 2:STE 100
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-6923
Practice Address - Country:US
Practice Address - Phone:801-475-7100
Practice Address - Fax:801-475-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========OtherTIN