Healthcare Provider Details

I. General information

NPI: 1669603577
Provider Name (Legal Business Name): SPECTRUM HEALTH URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 07/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2332 ALPINE AVE NW
GRAND RAPIDS MI
49544-1955
US

IV. Provider business mailing address

PO BOX 2469
GRAND RAPIDS MI
49501-2469
US

V. Phone/Fax

Practice location:
  • Phone: 616-391-6220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRAD SHER
Title or Position: DIRECTOR
Credential:
Phone: 616-486-6653