Provider Demographics
NPI:1700134160
Name:PINNACLE HEALTHCARE SOLUTIONS LLC
Entity type:Organization
Organization Name:PINNACLE HEALTHCARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARIAH
Authorized Official - Middle Name:JESSIC
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD,MPH
Authorized Official - Phone:918-756-4345
Mailing Address - Street 1:1101 S BELMONT AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-6315
Mailing Address - Country:US
Mailing Address - Phone:918-756-4345
Mailing Address - Fax:918-758-3507
Practice Address - Street 1:1101 S BELMONT AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6315
Practice Address - Country:US
Practice Address - Phone:918-756-4345
Practice Address - Fax:918-758-3507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22198261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center