Healthcare Provider Details

I. General information

NPI: 1093719783
Provider Name (Legal Business Name): EDWARD W. SPARROW HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 S 2ND ST STE 120
CARSON CITY MI
48811-9650
US

IV. Provider business mailing address

3301 E MICHIGAN AVE STE A
LANSING MI
48912-4641
US

V. Phone/Fax

Practice location:
  • Phone: 989-584-3272
  • Fax: 989-584-0541
Mailing address:
  • Phone: 517-253-6310
  • Fax: 517-253-6315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301004178
License Number StateMI

VIII. Authorized Official

Name: LISA STANDISH
Title or Position: OUTPATIENT PHARMACY DIRECTOR
Credential: R.PH.
Phone: 517-253-6313