Organization
SUMMIT SERVICES & SUPPLIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MADONNA EM LONG (CEO)
(307) 877-2993
Entity
Organization
Contact information
Practice address
806 PINE AVE, KEMMERER, WY 83101-2900
(307) 877-2993
Mailing address
PO BOX 1074, KEMMERER, WY 83101-1074
(307) 877-2993
(307) 316-2910
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2110ILGVF
—
CA
05
—
7911390001
—
WY
Enumeration date
02/08/2021
Last updated
10/18/2022
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