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Organization
SPECTRUM HEALTH
Active
Organization
SPECTRUM HEALTH
Active
Parent organization
SPECTRUM HEALTH SYSTEM
Other names
Spectrum Health- Lake Drive Surgery Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPECTRUM HEALTH SYSTEM
Authorized official
MR. DOUGALS D WELDAY (VP FINANCE)
(616) 391-2525
Entity
Organization
Contact information
Practice address
4069 LAKE DR SE, SUITE 210, GRAND RAPIDS, MI 49546-8816
(616) 285-1120
Mailing address
100 MICHIGAN ST NE, MC 406, GRAND RAPIDS, MI 49503-2560
(616) 391-1774
(616) 774-7699
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
416835
MI
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
09/22/2005
Last updated
07/29/2014
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