1821347741 NPI number — SPRING ARBOR UNIVERSITY

Table of content: (NPI 1821347741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821347741 NPI number — SPRING ARBOR UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPRING ARBOR UNIVERSITY
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:
Provider Other Organization Name Type Code:
6
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:
1821347741
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 EAST MAIN STREET
Provider Second Line Business Mailing Address:
C/O SPRING ARBOR UNIVERSITY
Provider Business Mailing Address City Name:
SPRING ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49283-9701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-750-6352
Provider Business Mailing Address Fax Number:
517-750-6625

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 EAST MAIN STREET
Provider Second Line Business Practice Location Address:
SPRING ARBOR UNIVERSITY
Provider Business Practice Location Address City Name:
SPRING ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49283-9701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-750-6352
Provider Business Practice Location Address Fax Number:
517-750-6625
Provider Enumeration Date:
09/06/2012

Additional Information

Authorized Official

Authorized Official Last Name:
VANDERHILL
Authorized Official First Name:
DAN
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
ASSOCIATE V.P. FOR STUDENT DEVELOPM
Authorized Official Telephone Number:
517-750-6367

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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