Provider Demographics
NPI:1396416186
Name:PINNACLE DERMATOLOGY, SC
Entity Type:Organization
Organization Name:PINNACLE DERMATOLOGY, SC
Other - Org Name:
Other - Org Type:
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 1:701 E ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5170
Practice Address - Country:US
Practice Address - Phone:704-289-9448
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:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site