Provider Demographics
NPI:1568515104
Name:SUMMIT MEDICAL HEALTHCARE, LLC
Entity Type:Organization
Organization Name:SUMMIT MEDICAL HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-876-8110
Mailing Address - Street 1:91 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1122
Mailing Address - Country:US
Mailing Address - Phone:845-876-8110
Mailing Address - Fax:
Practice Address - Street 1:91 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1122
Practice Address - Country:US
Practice Address - Phone:845-876-8110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WER201Medicare ID - Type Unspecified