Provider Demographics
NPI:1225923238
Name:SUMMIT COMMUNITY CARE CLINIC, INC.
Entity type:Organization
Organization Name:SUMMIT COMMUNITY CARE CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:COGDILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-686-4040
Mailing Address - Street 1:PO BOX 202058
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-2058
Mailing Address - Country:US
Mailing Address - Phone:970-686-4040
Mailing Address - Fax:970-692-8301
Practice Address - Street 1:360 PEAK ONE DR STE 380
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-5870
Practice Address - Country:US
Practice Address - Phone:970-668-4040
Practice Address - Fax:970-692-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental