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General NPI Number Information
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NPI Number | 1609491000
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Entity Type | Organization
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Legal Business Name | SPECTRUM HEALTH HOSPITALS
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Dates
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Enumeration Date | 06/11/2020
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 2750 E BELTLINE AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-8614
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Country | US
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Telephone | 616-774-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MICHIGAN ST NE # MC845
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2560
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSES MANAGER
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Name | ELISABETH LACEY
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Credential |
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Telephone | 616-486-6630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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