Provider Demographics
NPI:1821408261
Name:PINNACLE HEALTH MEDICAL SERVICES
Entity Type:Organization
Organization Name:PINNACLE HEALTH MEDICAL SERVICES
Other - Org Name:PINNACLEHEALTH BONE AND JOINT CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-231-8245
Mailing Address - Street 1:409 S 2ND ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4310 LONDONDERRY RD
Practice Address - Street 2:FIRST FLOOR, SUITE 1-B
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5300
Practice Address - Country:US
Practice Address - Phone:717-791-2620
Practice Address - Fax:717-791-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100766676 0064Medicaid
PA029490Medicare PIN