Provider Demographics
NPI:1497713499
Name:PINNACLE SERVICES WINCHESTER, INC.
Entity Type:Organization
Organization Name:PINNACLE SERVICES WINCHESTER, INC.
Other - Org Name:EVERGREEN HEALTH AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:RANBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-361-7559
Mailing Address - Street 1:380 MILLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4453
Mailing Address - Country:US
Mailing Address - Phone:540-667-7010
Mailing Address - Fax:540-667-3115
Practice Address - Street 1:380 MILLWOOD AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4453
Practice Address - Country:US
Practice Address - Phone:540-667-7010
Practice Address - Fax:540-667-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2684314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA495142Medicare ID - Type Unspecified