Provider Demographics
NPI:1326405903
Name:SUMMIT URGENT CARE, LLC
Entity Type:Organization
Organization Name:SUMMIT URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARVELAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-252-7552
Mailing Address - Street 1:1825 HIGHWAY 34 E
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-6423
Mailing Address - Country:US
Mailing Address - Phone:770-252-7552
Mailing Address - Fax:678-904-2188
Practice Address - Street 1:749 LANIER AVE W
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7658
Practice Address - Country:US
Practice Address - Phone:770-252-7552
Practice Address - Fax:678-904-2188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA66151261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care