Provider Demographics
NPI:1790506673
Name:PINNACLE LIFE INNOVATIONS LLC
Entity type:Organization
Organization Name:PINNACLE LIFE INNOVATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KAMOLIDDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAJMIDDINOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:279-786-7439
Mailing Address - Street 1:6926 SHANNON WILLOW RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-1335
Mailing Address - Country:US
Mailing Address - Phone:279-786-7439
Mailing Address - Fax:
Practice Address - Street 1:6926 SHANNON WILLOW RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-1335
Practice Address - Country:US
Practice Address - Phone:279-786-7439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies