Healthcare Provider Details

I. General information

NPI: 1952301608
Provider Name (Legal Business Name): SUMMIT HME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11930 STARCREST DR STE 108
SAN ANTONIO TX
78247-4102
US

IV. Provider business mailing address

11930 STARCREST DR STE 108
SAN ANTONIO TX
78247-4102
US

V. Phone/Fax

Practice location:
  • Phone: 210-521-9800
  • Fax: 210-682-9143
Mailing address:
  • Phone: 210-521-9800
  • Fax: 210-682-9143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SHAWN MCCORMICK
Title or Position: OWNER
Credential:
Phone: 210-521-9800