Provider Demographics
NPI:1952319733
Name:PINNACLE HEALTH MANAGEMENT, LLP
Entity Type:Organization
Organization Name:PINNACLE HEALTH MANAGEMENT, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-754-6545
Mailing Address - Street 1:105 WEBSTER ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-1227
Mailing Address - Country:US
Mailing Address - Phone:781-754-6545
Mailing Address - Fax:781-536-0016
Practice Address - Street 1:105 WEBSTER ST
Practice Address - Street 2:SUITE 8
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1227
Practice Address - Country:US
Practice Address - Phone:781-754-6545
Practice Address - Fax:781-536-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110069689AMedicaid
MAM19045OtherBLUE CROSS BLUE SHIELD
MAM21656Medicare PIN
MADD4635Medicare PIN
MAM19045OtherMASSACHUSETTS BLUE SHIELD