MEDICARE: SUMMIT CARE TRANSPORTATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1114633500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT CARE TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	11272 FELLOWS CREEK DR
Second Line	:
City	:	PLYMOUTH
State	:	MI
Zip	:	48170-6382
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15538 MICHIGAN AVE
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-2901
Country	:	US
Telephone Number	:	248-921-3712
Fax Number	:	248-282-7876

Authorized Official
Title or Position	:	OWNER
Name	:	TAHSINE BEYDOUN
Credential	:
Telephone Number	:	734-756-5506

Provider Enumeration Date	:	01/27/2023
Last Update Date	:	03/11/2026

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Directions to “SUMMIT CARE TRANSPORTATION LLC ” Practice Location

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