Provider Demographics
NPI:1912930934
Name:PINNACLE MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:PINNACLE MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ASHBY
Authorized Official - Suffix:JR
Authorized Official - Credentials:CFO
Authorized Official - Phone:352-854-9527
Mailing Address - Street 1:5400 SW HWY 200
Mailing Address - Street 2:SUITE 112
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474
Mailing Address - Country:US
Mailing Address - Phone:352-854-9527
Mailing Address - Fax:352-854-9519
Practice Address - Street 1:5400 SW HWY 200
Practice Address - Street 2:SUITE 112
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474
Practice Address - Country:US
Practice Address - Phone:352-854-9527
Practice Address - Fax:352-854-9519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2405332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2405OtherHOME MEDICAL EQUIPMENT
5033920001Medicare ID - Type Unspecified