Provider Demographics
NPI:1598863508
Name:PINNACLE HEALTH HOSPITALS
Entity Type:Organization
Organization Name:PINNACLE HEALTH HOSPITALS
Other - Org Name:PINNACLE HEALTH OUTPATIENT PSYCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGENDERFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-230-8200
Mailing Address - Street 1:PO BOX 8700
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17105-8700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:307 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1621
Practice Address - Country:US
Practice Address - Phone:717-782-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA39S760OtherCAPITAL BLUE CROSS
PA39S760Medicare ID - Type Unspecified