| Summit Healthcare Pediatrics | |
|
4951 S White Mountain Rd Bldg A Show Low AZ 85901-7801 | |
| (289) 537-6700 | |
| (928) 532-2159 |
| Full Name | Summit Healthcare Pediatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 4951 S White Mountain Rd Bldg A, Show Low, Arizona |
| Authorized Official Name and Position | Kenneth Robert Allen (CHIEF PRACTICE OFFICER) |
| Authorized Official Contact | 9285374375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Healthcare Pediatrics Po Box 3050 Show Low AZ 85902-3050 Ph: (928) 537-6393 | Summit Healthcare Pediatrics 4951 S White Mountain Rd Bldg A Show Low AZ 85901-7801 Ph: (289) 537-6700 |
| NPI Number | 1942701693 |
|---|---|
| Provider Enumeration Date | 02/27/2018 |
| Last Update Date | 12/09/2019 |
| Medicare PECOS PAC ID | 8729205737 |
|---|---|
| Medicare Enrollment ID | O20180503002577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942701693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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