Provider Demographics
NPI:1538869953
Name:SUMMIT TEC INC
Entity type:Organization
Organization Name:SUMMIT TEC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FARID
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:IDRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-418-4998
Mailing Address - Street 1:333 PEACHBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-2361
Mailing Address - Country:US
Mailing Address - Phone:470-418-4998
Mailing Address - Fax:
Practice Address - Street 1:53 PERIMETER CTR E STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-2211
Practice Address - Country:US
Practice Address - Phone:470-418-4998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)