Organization
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
University of Michigan Health-Sparrow Palliative Care, Sparrow Palliative Care Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARROW HEALTH SYSTEM
Authorized official
MISTY GUNTER RUSSIAN (SUPERVISOR, PROVIDER ENROLLMENT)
(517) 253-6308
Entity
Organization
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-2050
(517) 487-0115
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 364-2050
(517) 487-0115
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50-0-C3-1557-0
BCBS NP GROUP #
MI
01
—
70-0-C3-1541-0
BCBS PHYSICIAN GRP #
MI
Enumeration date
11/16/2007
Last updated
03/27/2024
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