Provider Demographics
NPI:1558129569
Name:SUMMIT PRIMARY CARE
Entity Type:Organization
Organization Name:SUMMIT PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-993-5651
Mailing Address - Street 1:75 PRINTERS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3142
Mailing Address - Country:US
Mailing Address - Phone:303-993-5651
Mailing Address - Fax:303-552-5730
Practice Address - Street 1:2301 E PIKES PEAK AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-8006
Practice Address - Country:US
Practice Address - Phone:719-373-1212
Practice Address - Fax:719-203-2611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty