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Organization
WESTERN KY MEDICAL, LLC
Active
Organization
WESTERN KY MEDICAL, LLC
Active
Parent organization
PINNACLE TREATMENT CENTERS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINNACLE TREATMENT CENTERS, INC
Authorized official
ROBYN TANIS (EXECUTIVE DIRECTOR PRACTICE MGMT)
(856) 533-8762
Entity
Organization
Contact information
Practice address
609 HAMMOND PLZ, HOPKINSVILLE, KY 42240-4971
(270) 887-8333
Mailing address
1317 ROUTE 73 STE 200, MOUNT LAUREL, NJ 08054-2202
(856) 439-6111
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
810381
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
810381
STATE LICNESE
KY
Enumeration date
04/07/2014
Last updated
12/20/2019
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