Provider Demographics
NPI:1679980007
Name:SUMMIT NATIONAL DME LLC
Entity Type:Organization
Organization Name:SUMMIT NATIONAL DME LLC
Other - Org Name:SUMMIT MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:6773
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-699-3649
Mailing Address - Street 1:7819 E GREENWAY RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1623
Mailing Address - Country:US
Mailing Address - Phone:480-699-3649
Mailing Address - Fax:866-840-3323
Practice Address - Street 1:7819 E GREENWAY RD
Practice Address - Street 2:SUITE 6
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1623
Practice Address - Country:US
Practice Address - Phone:480-699-3649
Practice Address - Fax:866-840-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies