=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063709822
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUMMIT HEALTH & REHAB SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2011
-----------------------------------------------------
Last Update Date | 12/17/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4131 ANDREW JACKSON PKWY
-----------------------------------------------------
City | HERMITAGE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37076-2270
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-885-9989
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4109 HIGHWAY 98 W
-----------------------------------------------------
City | SUMMIT
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39666-9132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACCOUNTS PAYABLE
-----------------------------------------------------
Name | DEBBIE WHITE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 601-276-3909
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------