Provider Demographics
NPI:1861199986
Name:SUMMIT PRIMARY CARE
Entity type:Organization
Organization Name:SUMMIT PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEILL
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:303-993-5651
Mailing Address - Street 1:850 E HARVARD AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5076
Mailing Address - Country:US
Mailing Address - Phone:303-993-5651
Mailing Address - Fax:303-552-5730
Practice Address - Street 1:2317 SAN JUAN AVE
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-3340
Practice Address - Country:US
Practice Address - Phone:719-388-3232
Practice Address - Fax:719-383-2337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty