Healthcare Provider Details

I. General information

NPI: 1568929917
Provider Name (Legal Business Name): SIMON COMMUNITY TRANSPORTATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 02/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5232 OAKMAN BLVD
DEARBORN MI
48126-3318
US

IV. Provider business mailing address

5232 OAKMAN BLVD
DEARBORN MI
48126-3318
US

V. Phone/Fax

Practice location:
  • Phone: 313-725-1845
  • Fax: 313-633-1086
Mailing address:
  • Phone: 313-725-1845
  • Fax: 313-633-1086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: SENAN SALEH
Title or Position: FOUNDER & PRESIDENT
Credential:
Phone: 313-725-1845