Provider Demographics
NPI:1669729307
Name:PINNACLE HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:PINNACLE HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-238-5018
Mailing Address - Street 1:10432 BALLS FORD RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2514
Mailing Address - Country:US
Mailing Address - Phone:917-238-5018
Mailing Address - Fax:
Practice Address - Street 1:10432 BALLS FORD RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2514
Practice Address - Country:US
Practice Address - Phone:917-238-5018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-13871251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health