Healthcare Provider Details

I. General information

NPI: 1447333430
Provider Name (Legal Business Name): SPARROW DEVELOPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 E GRAND RIVER AVE
LANSING MI
48912-4300
US

IV. Provider business mailing address

1100 W SAGINAW ST SUITE 100
LANSING MI
48915-1925
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-8640
  • Fax: 517-364-8644
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301006694
License Number StateMI

VIII. Authorized Official

Name: RONALD MELARAGNI
Title or Position: ADMIN DIR
Credential: RPH
Phone: 517-364-7455