Healthcare Provider Details

I. General information

NPI: 1518880970
Provider Name (Legal Business Name): SUMMIT SAGE GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 HARD SCRABBLE RD STE 100-1000
COLUMBIA SC
29229-8625
US

IV. Provider business mailing address

4760 HARD SCRABBLE RD STE 100-1000
COLUMBIA SC
29229-8625
US

V. Phone/Fax

Practice location:
  • Phone: 803-210-0420
  • Fax:
Mailing address:
  • Phone: 803-210-0420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: CORAETTA ANDRENA ROBINSON-HOWELL
Title or Position: PRESIDENT
Credential:
Phone: 803-210-0420