Provider Demographics
NPI:1497461032
Name:SUMMIT HOME HEALTH LLC
Entity Type:Organization
Organization Name:SUMMIT HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-278-7008
Mailing Address - Street 1:301 LILAC DR STE 110
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-7297
Mailing Address - Country:US
Mailing Address - Phone:405-480-0446
Mailing Address - Fax:
Practice Address - Street 1:301 LILAC DR STE 110
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-7297
Practice Address - Country:US
Practice Address - Phone:405-480-0446
Practice Address - Fax:405-480-0448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health