Provider Demographics
NPI:1033481585
Name:SUMMIT HEALTH CARE, INC
Entity Type:Organization
Organization Name:SUMMIT HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WHITEHAIR
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:304-290-7508
Mailing Address - Street 1:31452 VETERANS MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:TERRA ALTA
Mailing Address - State:WV
Mailing Address - Zip Code:26764-9715
Mailing Address - Country:US
Mailing Address - Phone:304-290-7508
Mailing Address - Fax:304-789-3195
Practice Address - Street 1:31452 VETERANS MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:TERRA ALTA
Practice Address - State:WV
Practice Address - Zip Code:26764-9715
Practice Address - Country:US
Practice Address - Phone:304-290-7508
Practice Address - Fax:304-789-3195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27929363LP2300X
WV30529363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty