Provider Demographics
NPI:1548733066
Name:SUMMT MEDICAL GROUP, INC
Entity type:Organization
Organization Name:SUMMT MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AVP REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-655-2583
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-905-3070
Mailing Address - Fax:859-441-1348
Practice Address - Street 1:1400 GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:KY
Practice Address - Zip Code:41071
Practice Address - Country:US
Practice Address - Phone:859-905-3070
Practice Address - Fax:859-441-1348
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMT MEDICAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care