Organization
SAINT MARINA HOME DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN JWAD (OWNER)
(248) 535-5685
Entity
Organization
Contact information
Practice address
26711 NORTHWESTERN HWY STE 125, SOUTHFIELD, MI 48033-2170
(248) 535-5685
Mailing address
26711 NORTHWESTERN HWY STE 125, SOUTHFIELD, MI 48033-2170
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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