Provider Demographics
NPI:1164583456
Name:SUMMIT HOME RESPIRATORY SERVICES, INC
Entity Type:Organization
Organization Name:SUMMIT HOME RESPIRATORY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ECKHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-596-5007
Mailing Address - Street 1:1085 BUSINESS LN STE 2
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-8470
Mailing Address - Country:US
Mailing Address - Phone:239-596-5000
Mailing Address - Fax:239-596-5017
Practice Address - Street 1:1467 RAIL HEAD BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-8444
Practice Address - Country:US
Practice Address - Phone:239-596-5000
Practice Address - Fax:239-596-5017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL111332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL027397096Medicaid
FL027397001Medicaid
FL027397098Medicaid
FL027397000Medicaid
FL027397002Medicaid
FL027397079Medicaid
FL027397007Medicaid
FL027397096Medicaid