MEDICARE: SUMMIT HEALTHCARE ASSOCIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0203X	Radiation Oncology Clinic/Center	3376	AZ
2	261QX0200X	Oncology Clinic/Center	3376	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083736128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT HEALTHCARE ASSOCIATION

Provider Business Mailing Address
First Line	:	2500 E HUNT ST
Second Line	:	SUITE H
City	:	SHOW LOW
State	:	AZ
Zip	:	85901-7954
Country	:	US
Telephone Number	:	928-537-6937
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 E HUNT DR STE H-J
Second Line	:
City	:	SHOW LOW
State	:	AZ
Zip	:	85901-7954
Country	:	US
Telephone Number	:	928-537-6937
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	DAVID ROTHENBERGER
Credential	:
Telephone Number	:	375-928-6375

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	06/11/2025

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Directions to “SUMMIT HEALTHCARE ASSOCIATION ” Practice Location

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