Organization
SPECTRUM HEALTH HOSPITAL HEMOPHILIA
Active
Parent organization
SPECTRUM HEALTH HOSPITAL
Other names
SHH Hemophilia (& Pharmacy)
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPECTRUM HEALTH HOSPITAL
Authorized official
KNAUS J RONALD (CORPORATE CONTROLLER)
(616) 774-7771
Entity
Organization
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-1774
Mailing address
PO BOX 2127, GRAND RAPIDS, MI 49501-2127
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301003540
MI
3336H0001X
Home Infusion Therapy Pharmacy
5301003540
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
940D121370
BCBS GROUP
MI
Enumeration date
03/06/2009
Last updated
10/26/2023
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