Basic Information
| Provider Information | |||||||||
| NPI: | 1790263564 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PINNACLE HEALTH MEDICAL SERVICES | ||||||||
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| OtherOrganizationName: | UPMC PINNACLE WOUND AND HYPERBARIC CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 409 S 2ND ST STE 2F | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171041612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172318929 | ||||||||
| FaxNumber: | 7172215673 | ||||||||
| Practice Location | |||||||||
| Address1: | 3130 GRANDVIEW RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173319134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173166999 | ||||||||
| FaxNumber: | 7173166994 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2018 | ||||||||
| LastUpdateDate: | 09/10/2018 | ||||||||
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| AuthorizedOfficialLastName: | MARKLEY | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR VP | ||||||||
| AuthorizedOfficialTelephone: | 7172318210 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | 207PE0005X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | Undersea and Hyperbaric Medicine |
No ID Information.