Healthcare Provider Details

I. General information

NPI: 1164583456
Provider Name (Legal Business Name): SUMMIT HOME RESPIRATORY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1467 RAIL HEAD BLVD
NAPLES FL
34110-8444
US

IV. Provider business mailing address

1085 BUSINESS LN STE 2
NAPLES FL
34110-8470
US

V. Phone/Fax

Practice location:
  • Phone: 239-596-5000
  • Fax: 239-596-5017
Mailing address:
  • Phone: 239-596-5000
  • Fax: 239-596-5017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number111
License Number StateFL

VIII. Authorized Official

Name: NANCY ECKHARDT
Title or Position: PRESIDENT/CEO
Credential:
Phone: 239-596-5007