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Organization

EDWARD W. SPARROW HOSPITAL ASSOCIATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. PAULA M. REICHLE (CHIEF FINANCIAL OFFICER)
(517) 364-1000
Entity
Organization

Contact information

Practice address
1215 E. MICHIGAN AVENUE, LANSING, MI 48909-7980
(517) 364-6000
(517) 364-6009
Mailing address
P.O. BOX 30480, 1215 E. MICHIGAN AVENUE, LANSING, MI 48909-7980
(517) 364-6000
(517) 364-6009

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00025
BLUE CROSS, BCN
MI
01
200000000005
PHP
MI
05
301557293
MI
Enumeration date
08/16/2006
Last updated
11/09/2016
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