Healthcare Provider Details
I. General information
NPI: 1821938689
Provider Name (Legal Business Name): SUMMIT MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
505 MORRIS AVE STE 101
SPRINGFIELD NJ
07081-1032
US
IV. Provider business mailing address
1143 MAPLE CT
MOUNTAINSIDE NJ
07092-2201
US
V. Phone/Fax
- Phone: 973-941-8955
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROSINA
CARUVANA
Title or Position: PRESIDENT
Credential:
Phone: 973-941-8955