Provider Demographics
NPI:1891811782
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:
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:517-364-1227
Practice Address - Street 1:1022 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1330
Practice Address - Country:US
Practice Address - Phone:989-463-2384
Practice Address - Fax:989-463-8402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI383243561332B00000X, 332BX2000X, 335E00000X
MI332BP3500X
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI874323233Medicaid
MI540B902740OtherBCBS ALMA
MI0376790004Medicare NSC
MI874323233Medicaid