Provider Demographics
NPI:1366611212
Name:UNIVERSAL SUMMIT GROUP INC.
Entity type:Organization
Organization Name:UNIVERSAL SUMMIT GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LOLITA
Authorized Official - Middle Name:LYDIA
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-335-8744
Mailing Address - Street 1:19115 GREEN FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033-7807
Mailing Address - Country:US
Mailing Address - Phone:408-335-8744
Mailing Address - Fax:
Practice Address - Street 1:5880 DISTRICT BLVD STE 5.5
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2102
Practice Address - Country:US
Practice Address - Phone:408-335-8744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier