# SUMMIT SURGICAL SUITES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southwest Surgical Suites
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154322410
- **Authorized official:** KRISTY MUSIC (DIRECTOR OF PROVIDER ENROLLMENT-AO)
- **Authorized official phone:** (615) 465-7377

## Contact information

- **Practice address:** 7920 W JEFFERSON BLVD, SUITE 210, FORT WAYNE, IN 46804-4168
- **Practice address phone:** (260) 434-2022
- **Practice address fax:** (260) 434-2023
- **Mailing address:** 7920 W JEFFERSON BLVD, SUITE 210, FORT WAYNE, IN 46804-4168
- **Mailing address phone:** (260) 434-2022
- **Mailing address fax:** (260) 434-2023

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 05-003212-1 | IN | Yes |

## Other

- **Enumeration date:** 08/09/2005
- **Last updated:** 08/12/2024