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General NPI Number Information
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NPI Number | 1093719783
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Entity Type | Organization
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Legal Business Name | EDWARD W. SPARROW HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 245 S 2ND ST STE 120
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City | CARSON CITY
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State | MI
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Zip | 48811-9650
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Country | US
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Telephone | 989-584-3272
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Fax | 989-584-0541
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Provider Business Mailing Address
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Address Line | 3301 E MICHIGAN AVE STE A
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City | LANSING
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State | MI
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Zip | 48912-4641
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Country | US
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Telephone | 517-253-6310
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Fax | 517-253-6315
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Authorized Official
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Title or Position | OUTPATIENT PHARMACY DIRECTOR
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Name | LISA STANDISH
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Credential | R.PH.
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Telephone | 517-253-6313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301004178
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License Number State | MI
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