Provider Demographics
NPI:1790104206
Name:SPECTRUM HEALTH UNITED
Entity Type:Organization
Organization Name:SPECTRUM HEALTH UNITED
Other - Org Name:COREWELL HEALTH GREENVILLE HOSPITAL MULTISPECIALTY CENTER - LAKEVIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, PROVIDER SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-349-1616
Mailing Address - Street 1:100 MICHIGAN ST NE
Mailing Address - Street 2:MC845
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-486-6790
Mailing Address - Fax:
Practice Address - Street 1:8650 HOWARD CITY EDMORE RD
Practice Address - Street 2:
Practice Address - City:LAKEVIEW
Practice Address - State:MI
Practice Address - Zip Code:48850-7102
Practice Address - Country:US
Practice Address - Phone:989-352-6474
Practice Address - Fax:989-352-8451
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPECTRUM HEALTH UNITED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-11
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care