Provider Demographics
NPI:1740618594
Name:PINNACLE COMPOUNDING, LLLP
Entity Type:Organization
Organization Name:PINNACLE COMPOUNDING, LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-435-9287
Mailing Address - Street 1:PO BOX 1615
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59806-1615
Mailing Address - Country:US
Mailing Address - Phone:855-466-1076
Mailing Address - Fax:406-541-6267
Practice Address - Street 1:1120 KENSINGTON AVE
Practice Address - Street 2:SUITE E
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-5619
Practice Address - Country:US
Practice Address - Phone:406-541-6121
Practice Address - Fax:406-541-6267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy