Provider Demographics
NPI:1154650778
Name:SPARROW COMMUNITY CARE
Entity Type:Organization
Organization Name:SPARROW COMMUNITY CARE
Other - Org Name:SPARROW MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARWIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-364-2115
Mailing Address - Street 1:915 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1417
Mailing Address - Country:US
Mailing Address - Phone:517-364-2115
Mailing Address - Fax:517-371-1227
Practice Address - Street 1:245 S 2ND ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:MI
Practice Address - Zip Code:48811-9650
Practice Address - Country:US
Practice Address - Phone:989-584-3272
Practice Address - Fax:989-584-0541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BX2000X
MI332BP3500X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier