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General NPI Number Information
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NPI Number | 1164984845
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Entity Type | Organization
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Legal Business Name | SMART DIALYSIS INC
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 04/02/2019
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Provider Practice Location Address
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Address Line | 16181 HUBBELL ST
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City | DETROIT
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State | MI
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Zip | 48235-4026
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Country | US
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Telephone | 313-632-6527
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Fax | 248-344-1317
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Provider Business Mailing Address
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Address Line | 47039 MANHATTAN CIR
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City | NOVI
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State | MI
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Zip | 48374-1831
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Country | US
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Telephone | 248-935-0935
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Fax | 248-344-1317
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Authorized Official
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Title or Position | DIRECTOR
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Name | DESTINEE FRANKLIN
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Credential |
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Telephone | 248-935-3095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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