Provider Demographics
NPI:1629548896
Name:SUMMIT HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:SUMMIT HOME HEALTHCARE LLC
Other - Org Name:GLODAN TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-426-4929
Mailing Address - Street 1:1229 GARRISONVILLE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-3655
Mailing Address - Country:US
Mailing Address - Phone:540-426-4929
Mailing Address - Fax:
Practice Address - Street 1:1229 GARRISONVILLE RD STE 204
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-3655
Practice Address - Country:US
Practice Address - Phone:540-426-4929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHCO-212313OtherVDH HOME CARE LICENSED
VA754OtherDMV NEMT CERTIFICATION