Provider Demographics
NPI:1235420092
Name:SPARROW EATON HOSPITAL
Entity Type:Organization
Organization Name:SPARROW EATON HOSPITAL
Other - Org Name:SPARROW EATON HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-543-1050
Mailing Address - Street 1:321 E HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1629
Mailing Address - Country:US
Mailing Address - Phone:517-543-1050
Mailing Address - Fax:517-543-0875
Practice Address - Street 1:321 E HARRIS ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1629
Practice Address - Country:US
Practice Address - Phone:517-543-1050
Practice Address - Fax:517-543-0875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B31000OtherBCBSM