Provider Demographics
NPI:1679299267
Name:PINNACLE TRANSPORT LLC, DBA PINNACLE CARE SERVICES
Entity Type:Organization
Organization Name:PINNACLE TRANSPORT LLC, DBA PINNACLE CARE SERVICES
Other - Org Name:PINNACLE CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MAOBUGHICHI
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-215-6701
Mailing Address - Street 1:5551 DANUBE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8745
Mailing Address - Country:US
Mailing Address - Phone:720-215-6701
Mailing Address - Fax:720-328-8010
Practice Address - Street 1:5551 DANUBE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-8745
Practice Address - Country:US
Practice Address - Phone:720-215-6701
Practice Address - Fax:720-328-8010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINNACLE TRANSPORT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-14
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10C521OtherCDPHE
CO20121327376OtherCOLORADO SECRETARY OF STATE ID NUMBER