Healthcare Provider Details

I. General information

NPI: 1689101784
Provider Name (Legal Business Name): SPECTRUM HEALTH HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2017
Last Update Date: 05/24/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 CEDAR ST NE
GRAND RAPIDS MI
49503-1370
US

IV. Provider business mailing address

100 MICHIGAN ST NE
GRAND RAPIDS MI
49503-2560
US

V. Phone/Fax

Practice location:
  • Phone: 616-486-3001
  • Fax:
Mailing address:
  • Phone: 616-643-9143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1070000195
License Number StateMI

VIII. Authorized Official

Name: MATTHEW E COX
Title or Position: SVP, FINANCE SHHG
Credential:
Phone: 616-391-1663