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General NPI Number Information
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NPI Number | 1881620425
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Entity Type | Organization
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Legal Business Name | SUMMIT HEALTH
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 110 CARNIE BLVD
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City | VOORHEES
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State | NJ
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Zip | 08043-4515
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Country | US
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Telephone | 856-325-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 110 CARNIE BLVD
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City | VOORHEES
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State | NJ
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Zip | 08043-4515
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Country | US
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Telephone | 856-325-5800
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Fax |
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Authorized Official
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Title or Position | VP/COO
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Name | MRS. ADRIENNE KIRBY
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Credential | PH.D.
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Telephone | 856-355-6165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 70477
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License Number State | NJ
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