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General NPI Number Information
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NPI Number | 1093742249
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Entity Type | Organization
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Legal Business Name | SPARROW EATON HOSPITAL
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 321 E HARRIS ST
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City | CHARLOTTE
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State | MI
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Zip | 48813-1629
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Country | US
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Telephone | 517-543-1050
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Fax | 517-543-0875
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Provider Business Mailing Address
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Address Line | 321 E HARRIS ST
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City | CHARLOTTE
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State | MI
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Zip | 48813-1629
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Country | US
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Telephone | 517-543-1050
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Fax | 517-543-0875
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Authorized Official
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Title or Position | REGIONAL MANAGER, PROVIDER ENROLLME
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Name | MISTY GUNTER RUSSIAN
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Credential |
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Telephone | 517-253-6308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 231006
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License Number State | MI
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