Organization
SUMMIT FISCAL AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS R SMITH (PROGRAM DIRECTOR)
(612) 977-3952
Entity
Organization
Contact information
Practice address
724 CENTRAL AVE SE, MINNEAPOLIS, MN 55414-1121
(612) 977-3100
(612) 977-3980
Mailing address
724 CENTRAL AVE SE, MINNEAPOLIS, MN 55414-1121
(612) 977-3100
(612) 977-3980
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
M697635201
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M697635201
STATE UMPI NUMBER
MN
Enumeration date
03/01/2017
Last updated
03/01/2017
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