SUMMIT HEALTHCARE MEDICAL ASSOCIATES; NPI #1770700767

Contact Information

SUMMIT HEALTHCARE MEDICAL ASSOCIATES

2352 QUARTER HORSE TRAIL
OVERGAARD, AZ 85933

Phone: 928-535-3616
Fax: 928-532-2156
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for SUMMIT HEALTHCARE MEDICAL ASSOCIATES

NPI Number 1770700767

LBN Legal business name SUMMIT HEALTHCARE MEDICAL ASSOCIATES

Authorized official JILL BLUSE - (HEALTH PLAN CREDENTIALING COORDINAT)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 04/19/2007

Last updated 08/11/2025 - About 10 months ago

Identifiers

AZ	License #	H0132
AZ	Medicaid	950222

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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