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General NPI Number Information
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NPI Number | 1952651820
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Entity Type | Organization
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Legal Business Name | SPARROW COMMUNITY CARE
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 201 S COCHRAN AVE
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City | CHARLOTTE
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State | MI
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Zip | 48813-1550
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Country | US
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Telephone | 517-543-0978
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Fax | 517-541-1548
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Provider Business Mailing Address
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Address Line | 3301 E MICHIGAN AVE
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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 | 517-364-2115
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Fax | 517-371-1227
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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 | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | MI
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