SUMMIT HEALTHCARE MEDICAL ASSOCIATES NPI 1770700767

NPI Information

NPI: 1770700767
Provider Name: SUMMIT HEALTHCARE MEDICAL ASSOCIATES

Doing Business As: FAMILY MEDICINE AT BISON RANCH

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
2352 QUARTER HORSE TRAIL
OVERGAARD, AZ
ZIP 85933
Phone: (928) 535-3616
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SUMMIT HEALTHCARE MEDICAL ASSOCIATES is a rural health clinic center in Overgaard, AZ. SUMMIT HEALTHCARE MEDICAL ASSOCIATES NPI is 1770700767. The provider is registered as an organization entity type.
The provider Is Doing Business As Family Medicine At Bison Ranch.

The provider's business location address is:

2352 QUARTER HORSE TRAIL
OVERGAARD, AZ
ZIP 85933
Phone: (928) 535-3616
Fax: (928) 532-2156

The provider's authorized official is Jill Bluse .
The authorized official title is Health Plan Credentialing Coordinat and has the following contact phone number (928) 537-6393.

The enumeration date for this NPI number is 4/19/2007 and was last updated on 5/17/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	H0132	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	950222	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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