Provider Demographics
NPI:1356586747
Name:MARINA HOME HEALTH, LLC
Entity type:Organization
Organization Name:MARINA HOME HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-625-4312
Mailing Address - Street 1:709 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-2334
Mailing Address - Country:US
Mailing Address - Phone:419-625-4312
Mailing Address - Fax:416-502-4312
Practice Address - Street 1:709 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-2334
Practice Address - Country:US
Practice Address - Phone:419-625-4312
Practice Address - Fax:416-502-4312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3143217Medicaid
OH3143217Medicaid