Provider Demographics
NPI:1063670453
Name:ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.
Entity Type:Organization
Organization Name:ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.
Other - Org Name:ASPIRUS GRAND VIEW
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERMSIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-932-2525
Mailing Address - Street 1:N10565 GRANDVIEW LN
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-9622
Mailing Address - Country:US
Mailing Address - Phone:906-932-1500
Mailing Address - Fax:906-932-5630
Practice Address - Street 1:E6112 E BLUFFVIEW RD
Practice Address - Street 2:SUITE 102
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-9367
Practice Address - Country:US
Practice Address - Phone:906-932-1436
Practice Address - Fax:906-932-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4492290005Medicare NSC