MEDICARE: SUMMIT OHIO LEASING CO., LLC

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	314000000X	Skilled Nursing Facility	1893N	OH

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	:	1326039736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT OHIO LEASING CO., LLC

Provider Business Mailing Address
First Line	:	10123 ALLIANCE RD
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-4887
Country	:	US
Telephone Number	:	513-530-1808
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 SUMMIT GLEN DRIVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449
Country	:	US
Telephone Number	:	937-436-2273
Fax Number	:	937-436-4771

Authorized Official
Title or Position	:	SECRETARY / TREASURER
Name	:	CHARLES R STOLTZ
Credential	:
Telephone Number	:	513-530-1808

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	05/01/2025

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Directions to “SUMMIT OHIO LEASING CO., LLC ” Practice Location

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