Healthcare Provider Details

I. General information

NPI: 1114014594
Provider Name (Legal Business Name): SPECTRUM HEALTH HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 LAKE DRIVE SE SUITE 100
GRAND RAPIDS MI
49546-8292
US

IV. Provider business mailing address

100 MICHIGAN ST NE MC 406
GRAND RAPIDS MI
49503-2560
US

V. Phone/Fax

Practice location:
  • Phone: 616-391-3759
  • Fax: 616-391-3052
Mailing address:
  • Phone: 616-391-1774
  • Fax: 616-391-3052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW E COX
Title or Position: CFO
Credential:
Phone: 616-391-1663