MEDICARE: SUMMIT SERVICES COMPANY

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1205660032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT SERVICES COMPANY

Provider Business Mailing Address
First Line	:	3018 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2001
Country	:	US
Telephone Number	:	612-721-7776
Fax Number	:	612-722-3578

Provider Business Practice Location Address
First Line	:	3018 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2001
Country	:	US
Telephone Number	:	612-721-7776
Fax Number	:

Authorized Official
Title or Position	:	PRESEDENT
Name	:	MR. MAXWELL AFORO
Credential	:
Telephone Number	:	612-721-7776

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	08/26/2024

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