Provider Demographics
NPI:1437293511
Name:PINNACLE HEALTH CARE LLC
Entity Type:Organization
Organization Name:PINNACLE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-263-8808
Mailing Address - Street 1:1067 FOCH ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-2919
Mailing Address - Country:US
Mailing Address - Phone:817-263-8808
Mailing Address - Fax:817-263-8811
Practice Address - Street 1:1067 FOCH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2919
Practice Address - Country:US
Practice Address - Phone:817-263-8808
Practice Address - Fax:817-263-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001016312Medicaid
TX671586Medicare PIN