Provider Demographics
NPI:1891809059
Name:TRINITY REHABILITATION PINNACLE POINT
Entity Type:Organization
Organization Name:TRINITY REHABILITATION PINNACLE POINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHAMPION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-751-7122
Mailing Address - Street 1:5511 WALSH LN
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8941
Mailing Address - Country:US
Mailing Address - Phone:479-845-0845
Mailing Address - Fax:
Practice Address - Street 1:5511 WALSH LN
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8941
Practice Address - Country:US
Practice Address - Phone:479-845-0845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5F422OtherARKANSAS BCBS
AR5F422OtherARKANSAS BCBS