Provider Demographics
NPI:1649271552
Name:PINNACLE HEALTH CARE LLC
Entity type:Organization
Organization Name:PINNACLE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABHIJIT
Authorized Official - Middle Name:G
Authorized Official - Last Name:DESHPANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-248-0497
Mailing Address - Street 1:1460 N 16TH AVE
Mailing Address - Street 2:STE. B
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7102
Mailing Address - Country:US
Mailing Address - Phone:509-248-0497
Mailing Address - Fax:509-248-4167
Practice Address - Street 1:1460 N 16TH AVE
Practice Address - Street 2:STE. B
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7102
Practice Address - Country:US
Practice Address - Phone:509-248-0497
Practice Address - Fax:509-248-4167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
WAMD00033867261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7127699Medicaid
WA9056631OtherDME SUPPLIER FOR DSHS
WA1116938OtherDSHS
WA607333500OtherOFFICE OF WORKERS COMP
WAP00217647OtherMEDICARE RAILROAD NUMBER
WAG8882777Medicare PIN
WA7127699Medicaid
WAG8882778Medicare PIN
WA607333500OtherOFFICE OF WORKERS COMP