Provider Demographics
NPI:1437663465
Name:PINNACLE HOME CARE OF HILLSBOROUGH, INC.
Entity Type:Organization
Organization Name:PINNACLE HOME CARE OF HILLSBOROUGH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-534-7526
Mailing Address - Street 1:4023 TAMPA RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3212
Mailing Address - Country:US
Mailing Address - Phone:727-534-7526
Mailing Address - Fax:
Practice Address - Street 1:14920 CASEY RD STE 124
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2317
Practice Address - Country:US
Practice Address - Phone:727-534-7526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299994257251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health