| Organization Name: | SUMMIT MEDICAL CARE CENTER, LLC |
| NPI Number: | 1508229584 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRADLEY L RICHARDSON (MEMBER) |
| Mailing Address: | 54 Garden Ctr Broomfield |
| State: | CO US |
| Postal Code: | 800201730 |
| Phone Number: | 3034663232 |
| Fax Number: | 3034660110 |
| NPI Enumeration Date: | 03/29/2016 |
| NPI Last Update Date: | 03/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | APN-0991919-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |