MEDICARE: SUMMIT HEALTH INC.

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	171W00000X	Contractor	NONE	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00251967	OTHER	MI	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1225041213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT HEALTH INC.

Provider Business Mailing Address
First Line	:	27175 HAGGERTY RD
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48377-3626
Country	:	US
Telephone Number	:	248-799-8303
Fax Number	:	248-799-8927

Provider Business Practice Location Address
First Line	:	27175 HAGGERTY RD
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48377-3626
Country	:	US
Telephone Number	:	248-799-8303
Fax Number	:	248-799-8927

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD ALDEN PENINGTON
Credential	:
Telephone Number	:	248-799-8303

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	03/14/2012

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Directions to “SUMMIT HEALTH INC. ” Practice Location

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