Provider Demographics
NPI:1770762577
Name:SUMMIT INVESTMENT LLC
Entity type:Organization
Organization Name:SUMMIT INVESTMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALE
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-758-4867
Mailing Address - Street 1:13250 N 56TH ST SUITE 102
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617
Mailing Address - Country:US
Mailing Address - Phone:813-988-2300
Mailing Address - Fax:813-343-4549
Practice Address - Street 1:13250 N 56TH ST SUITE 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617
Practice Address - Country:US
Practice Address - Phone:813-988-2300
Practice Address - Fax:813-343-4549
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT INVESTMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-29
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 2300003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH230000OtherSTATE