Provider Demographics
NPI:1891486205
Name:EDWARD W SPARROW HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:EDWARD W SPARROW HOSPITAL ASSOCIATION
Other - Org Name:SPARROW IONIA PAIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO, UM HEALTH REGIONAL N
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DIMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-364-3480
Mailing Address - Street 1:8175 RELIABLE PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60686-0081
Mailing Address - Country:US
Mailing Address - Phone:517-253-6320
Mailing Address - Fax:517-253-6321
Practice Address - Street 1:205 S DEXTER ST
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-2001
Practice Address - Country:US
Practice Address - Phone:616-527-0558
Practice Address - Fax:616-527-1131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty