Provider Demographics
NPI:1225041213
Name:SUMMIT HEALTH INC.
Entity Type:Organization
Organization Name:SUMMIT HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALDEN
Authorized Official - Last Name:PENINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-799-8303
Mailing Address - Street 1:27175 HAGGERTY RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-3626
Mailing Address - Country:US
Mailing Address - Phone:248-799-8303
Mailing Address - Fax:248-799-8927
Practice Address - Street 1:27175 HAGGERTY RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-3626
Practice Address - Country:US
Practice Address - Phone:248-799-8303
Practice Address - Fax:248-799-8927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINONE171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00251967OtherRAILROAD MEDICARE
MIPHC030Medicare ID - Type UnspecifiedCENTRAL ID FOR ALL STATES