Provider Demographics
NPI:1528301561
Name:PINNACLE PHARMACY LLC
Entity type:Organization
Organization Name:PINNACLE PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELNUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-613-3289
Mailing Address - Street 1:3331 RAINBOW DR STE E
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-6264
Mailing Address - Country:US
Mailing Address - Phone:256-467-6337
Mailing Address - Fax:256-485-4543
Practice Address - Street 1:113 RAINBOW INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-8901
Practice Address - Country:US
Practice Address - Phone:256-467-6337
Practice Address - Fax:256-485-4543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336M0002X
AL1140583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2139436OtherPK