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General NPI Number Information
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NPI Number | 1700820065
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Entity Type | Organization
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Legal Business Name | SPARROW IONIA HOSPITAL
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 3565 S STATE RD
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City | IONIA
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State | MI
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Zip | 48846-9416
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Country | US
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Telephone | 616-523-1400
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Fax | 616-523-1429
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Provider Business Mailing Address
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Address Line | 8175 RELIABLE PKWY
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City | CHICAGO
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State | IL
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Zip | 60686-0081
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Country | US
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Telephone | 616-523-1400
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Fax | 616-523-1429
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Authorized Official
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Title or Position | SUPERVISOR, PROVIDER ENROLLMENT
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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 | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 340021
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License Number State | MI
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