Healthcare Provider Details
I. General information
NPI: 1649658121
Provider Name (Legal Business Name): SPECTRUM HEALTH HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/15/2015
Last Update Date: 05/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 MICHIGAN ST NE
GRAND RAPIDS MI
49503-2560
US
IV. Provider business mailing address
100 MICHIGAN ST NE MC 47
GRAND RAPIDS MI
49503-2560
US
V. Phone/Fax
- Phone: 616-391-1675
- Fax:
- Phone: 616-391-1675
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARNIE
BYERS
Title or Position: VP HEALTH MANAGEMENT SERVICES
Credential:
Phone: 616-486-6620