Provider Demographics
NPI:1790108140
Name:SUMMIT ORTHOPEDICS, LTD
Entity Type:Organization
Organization Name:SUMMIT ORTHOPEDICS, LTD
Other - Org Name:SUMMIT RECOVERY SUITES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF SURGERY CENTERS
Authorized Official - Prefix:
Authorized Official - First Name:BECKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-968-5438
Mailing Address - Street 1:3580 ARCADE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-7135
Mailing Address - Country:US
Mailing Address - Phone:651-968-5790
Mailing Address - Fax:651-968-5792
Practice Address - Street 1:3580 ARCADE ST STE 250
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55127-7135
Practice Address - Country:US
Practice Address - Phone:651-968-5790
Practice Address - Fax:651-968-5792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-21
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374566261QR0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care