Healthcare Provider Details

I. General information

NPI: 1750464780
Provider Name (Legal Business Name): EDWARD W. SPARROW HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 CHARLEVOIX DR
GRAND LEDGE MI
48837-2278
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 517-627-1670
  • Fax: 517-627-0068
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 TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301006695
License Number StateMI

VIII. Authorized Official

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