Organization
SPECTRUM HEALTH HOSPITALS
Active
Parent organization
SPECTRUM HEALTH SYSTEM
Other names
Spectrum Health Urgent Care Broadmoor
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPECTRUM HEALTH SYSTEM
Authorized official
MR. MARC A CHIRCOP (VP AMBULATORY SERVICES)
(616) 391-2796
Entity
Organization
Contact information
Practice address
3350 BROADMOOR AVE SE, KENTWOOD, MI 49512-2867
(616) 391-8020
(616) 391-8035
Mailing address
80 68TH STREET, GRAND RAPIDS, MI 59458-6980
(616) 391-8201
(616) 391-8202
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1236640006
DME
MI
Enumeration date
09/21/2006
Last updated
08/20/2007
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