1760710719 NPI number — EDWARD W SPARROW HOSPITAL ASSOCIATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760710719 NPI number — EDWARD W SPARROW HOSPITAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EDWARD W SPARROW HOSPITAL ASSOCIATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THORACIC CARDIOVASCULAR INSTITUTE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760710719
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3500 S CEDAR ST
Provider Second Line Business Mailing Address:
SUITE 116
Provider Business Mailing Address City Name:
LANSING
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48910-4699
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-887-2511
Provider Business Mailing Address Fax Number:
517-882-4144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1140 E. MICHGAN AVE
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-483-7550
Provider Business Practice Location Address Fax Number:
517-483-8436
Provider Enumeration Date:
12/03/2009

Additional Information

Authorized Official

Authorized Official Last Name:
GALLUPS
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
DIRECTOR BUSINESS OPERATION
Authorized Official Telephone Number:
517-887-2511

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com