Healthcare Provider Details

I. General information

NPI: 1649349317
Provider Name (Legal Business Name): EDWARD W. SPARROW HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E MICHIGAN AVE SUITE 310
LANSING MI
48912-1800
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 517-364-5380
  • Fax: 517-364-5387
Mailing address:
  • Phone: 517-364-7455
  • Fax: 517-364-7465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5301006723
License Number StateMI

VIII. Authorized Official

Name: MR. RONALD J MELARAGNI
Title or Position: ADMINISTRATIVE DIRECTOR
Credential: R.PH.
Phone: 517-364-7455