Healthcare Provider Details

I. General information

NPI: 1871606640
Provider Name (Legal Business Name): EDWARD W. SPARROW HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E. MICHIGAN AVENUE
LANSING MI
48909-7980
US

IV. Provider business mailing address

P.O. BOX 30480 1215 E. MICHIGAN AVENUE
LANSING MI
48909-7980
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-6000
  • Fax: 517-364-6009
Mailing address:
  • Phone: 517-364-6000
  • Fax: 517-364-6009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. PAULA M. REICHLE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 517-364-1000