Provider Demographics
NPI:1801974720
Name:SUMMIT SURGICAL CENTER, LLC
Entity type:Organization
Organization Name:SUMMIT SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:CASC
Authorized Official - Phone:856-247-7838
Mailing Address - Street 1:200 BOWMAN DRIVE SUITE D160
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043
Mailing Address - Country:US
Mailing Address - Phone:856-247-7800
Mailing Address - Fax:856-247-7858
Practice Address - Street 1:200 BOWMAN DRIVE, SUITE D160
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-247-7800
Practice Address - Fax:856-247-7858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
100419Medicare ID - Type Unspecified