MEDICARE: SUMMIT CARE

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1093509200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT CARE

Provider Business Mailing Address
First Line	:	3250 W 66TH ST APT 425
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-5512
Country	:	US
Telephone Number	:	612-544-4373
Fax Number	:

Provider Business Practice Location Address
First Line	:	3250 W 66TH ST APT 425
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-5512
Country	:	US
Telephone Number	:	612-544-4373
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. KAMIL HASSAN
Credential	:
Telephone Number	:	612-544-4373

Provider Enumeration Date	:	04/04/2025
Last Update Date	:	04/04/2025

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Directions to “SUMMIT CARE ” Practice Location

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