Summit Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

MG00806 Issued in AR

Legal business name

SUMMIT MEDICAL SUPPLY INC

Practice address

170 Commerce Rd
Suite 201
Conway, AR 72032-7112

Phone

(501) 327-5426

Fax

(501) 327-5881

NPI assigned

Nov 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Bryan Henry

Title

Owner

Phone

(501) 327-5426

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1326125063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2486",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720332486",
            "telephone_number": "501-327-5426",
            "fax_number": "501-327-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 COMMERCE RD",
            "address_2": "SUITE 201",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327112",
            "telephone_number": "501-327-5426",
            "fax_number": "501-327-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-327-5426",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "MG00806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9061334",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "129219",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DM1270",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240067000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432970700",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUE CROSS BLUE SHIELD",
            "identifier": "49980",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626353304",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034061",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelyn Nicole Sullivan, SLP
• Natalia Pellandini Sullivan, MS, LPC, LMFT
• Jordan Summers
• Savannah Summers, APRN
• Allison Kate Summey
• James Alfred Summitt, DDS
• Sherry A Summitt, R, MR
• Superior Health & Rehab LLC
• Surgical Associates of Conway PLC
• Allison Susa, ATC

• Durable Medical Equipment & Medical Supplies in Conway, AR
• Providers in Conway, AR by specialty
• Durable Medical Equipment & Medical Supplies in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.