Organization
SUMMIT HEALTH PRIMARY AND URGENT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED DERANEY CRNA (OWNER)
(480) 482-0934
Entity
Organization
Contact information
Practice address
120 HANDLEY RD BLDG 400 STE #410, TYRONE, GA 30290-3029
(678) 430-8478
Mailing address
PO BOX 935719, ATLANTA, GA 31193-5719
(678) 430-8478
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/07/2020
Last updated
10/02/2020
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