Organization
SUMMIT HEALTHCARE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN B JACOBS (CHIEF NURSING OFFICER)
(928) 537-6932
Entity
Organization
Contact information
Practice address
4951 SOUTH WHITE MOUNTAIN ROAD, BLDG A., SUITE 1500, SHOW LOW, AZ 85901
(928) 537-6336
(928) 532-3506
Mailing address
2200 E. SHOW LOW LAKE ROAD, SHOW LOW, AZ 85901
(928) 537-6321
(928) 537-7814
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470811
—
AZ
Enumeration date
12/17/2018
Last updated
07/19/2019
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