Provider Demographics
NPI:1992029375
Name:PINNACLE HEALTH MEDICAL SERVICES
Entity Type:Organization
Organization Name:PINNACLE HEALTH MEDICAL SERVICES
Other - Org Name:PH CARDIOVASCULAR AND THORACIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:MR
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:PO BOX 1286
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17108-1286
Mailing Address - Country:US
Mailing Address - Phone:717-231-8960
Mailing Address - Fax:717-231-8964
Practice Address - Street 1:205 S FRONT ST
Practice Address - Street 2:4TH FLOOR BMA
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1619
Practice Address - Country:US
Practice Address - Phone:717-231-8555
Practice Address - Fax:717-231-8568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007666760064Medicaid
PA1007666760064Medicaid