Organization Name: | SUMMIT HEALTHCARE ASSOCIATION |
NPI Number: | 1083736128 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH ROBERT ALLEN (COO) |
Mailing Address: | 2500 E Hunt St Suite H Show Low |
State: | AZ US |
Postal Code: | 859017954 |
Phone Number: | 9285376937 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2007 |
NPI Last Update Date: | 07/31/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QX0203X |
License Number: | 3376 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Oncology, Radiation |
Taxonomy Definition: |