Provider Demographics
NPI:1265859227
Name:SUMMIT OXYGEN, INC.
Entity Type:Organization
Organization Name:SUMMIT OXYGEN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:970-406-8518
Mailing Address - Street 1:PO BOX 722
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-0722
Mailing Address - Country:US
Mailing Address - Phone:970-406-8518
Mailing Address - Fax:888-977-3379
Practice Address - Street 1:117 S. 6TH AVE. SUITE A-1
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-0722
Practice Address - Country:US
Practice Address - Phone:970-406-8518
Practice Address - Fax:888-977-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28022567-0000332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies