Provider Demographics
NPI:1114265790
Name:SUMMIT MEDICAL DME
Entity Type:Organization
Organization Name:SUMMIT MEDICAL DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-699-3649
Mailing Address - Street 1:7819 E GREENWAY RD STE 9
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1719
Mailing Address - Country:US
Mailing Address - Phone:480-699-3649
Mailing Address - Fax:866-738-0808
Practice Address - Street 1:7819 E GREENWAY RD STE 9
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1719
Practice Address - Country:US
Practice Address - Phone:480-699-3649
Practice Address - Fax:866-738-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies