Organization
SPECTRUM HEALTH HOSPITALS
Active
Other names
DeVos Childrens Hospital End Stage Renal Disease, Corewell Health Grand Rapids Hospitals Pediatric Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW E COX (VICE PRESIDENT OF FINANCE)
(616) 391-1663
Entity
Organization
Contact information
Practice address
35 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2514
(616) 391-9000
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
261Q00000X
Clinic/Center
410040
MI
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
410040
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4695800
—
MI
Enumeration date
08/15/2005
Last updated
10/16/2023
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