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General NPI Number Information
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NPI Number | 1104406800
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Entity Type | Organization
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Legal Business Name | SUMMA HEALTH OUTPATIENT SERVICES LLC
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 10/11/2021
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Provider Practice Location Address
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Address Line | 3825 FISHCREEK RD STE 110
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City | STOW
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State | OH
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Zip | 44224-4316
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Country | US
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Telephone | 234-867-6964
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Fax |
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Provider Business Mailing Address
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Address Line | 525 E MARKET ST
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City | AKRON
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State | OH
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Zip | 44304-1619
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Country | US
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Telephone | 234-312-5656
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MICHELLE INGMIRE
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Credential |
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Telephone | 234-312-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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