MEDICARE: SPARROW IONIA HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1013079128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPARROW IONIA HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 1001
Second Line	:	520 E WASHINGTON ST
City	:	IONIA
State	:	MI
Zip	:	48846-6001
Country	:	US
Telephone Number	:	616-523-1400
Fax Number	:	616-523-1429

Provider Business Practice Location Address
First Line	:	550 E WASHINGTON ST
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846-2202
Country	:	US
Telephone Number	:	616-523-1400
Fax Number	:	616-523-1429

Authorized Official
Title or Position	:	CEO
Name	:	WILLIAM ROESER
Credential	:
Telephone Number	:	616-523-1400

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	03/05/2014

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Directions to “SPARROW IONIA HOSPITAL ” Practice Location

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