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NPI Code Detail

MEDICARE: EDWARD W. SPARROW HOSPITAL ASSOCIATION

MEDICARE: EDWARD W. SPARROW HOSPITAL ASSOCIATION
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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy5301004178MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12338728OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093719783
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDWARD W. SPARROW HOSPITAL ASSOCIATION
Provider Business Mailing Address
First Line : 3301 E MICHIGAN AVE STE A
Second Line :
City : LANSING
State : MI
Zip : 48912-4641
Country : US
Telephone Number : 517-253-6310
Fax Number : 517-253-6315
Provider Business Practice Location Address
First Line : 245 S 2ND ST STE 120
Second Line :
City : CARSON CITY
State : MI
Zip : 48811-9650
Country : US
Telephone Number : 989-584-3272
Fax Number : 989-584-0541
Authorized Official
Title or Position : OUTPATIENT PHARMACY DIRECTOR
Name : LISA STANDISH
Credential : R.PH.
Telephone Number : 517-253-6313
Provider Enumeration Date : 06/09/2005
Last Update Date : 07/01/2025

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