Provider Demographics
| NPI: | 1932143427 |
|---|---|
| Name: | PINNACLE HEALTH MEDICAL SERVICES |
| Entity type: | Organization |
| Organization Name: | PINNACLE HEALTH MEDICAL SERVICES |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | SENIOR VP |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CHRISTOPHER |
| Authorized Official - Middle Name: | P |
| Authorized Official - Last Name: | MARKLEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 717-231-8210 |
| Mailing Address - Street 1: | 409 S 2ND ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HARRISBURG |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 17104-1612 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 172-303-4167 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 409 S 2ND ST |
| Practice Address - Street 2: | |
| Practice Address - City: | HARRISBURG |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 17104-1612 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 717-231-8960 |
| Practice Address - Fax: | 717-231-8964 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-15 |
| Last Update Date: | 2019-01-17 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 2086S0120X | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | Group - Multi-Specialty |
| No | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Group - Multi-Specialty | |
| No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
| No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207VX0201X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology | Group - Multi-Specialty |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |
| No | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
| No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
| No | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| PA | 1007666760064 | Medicaid | |
| PA | 029490 | Medicare PIN |