Provider Demographics
NPI:1851849392
Name:SPARROW IONIA HOSPITAL
Entity type:Organization
Organization Name:SPARROW IONIA HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:N
Authorized Official - Last Name:ROESER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-523-1479
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:SARANAC
Mailing Address - State:MI
Mailing Address - Zip Code:48881-0007
Mailing Address - Country:US
Mailing Address - Phone:616-642-9408
Mailing Address - Fax:616-642-6940
Practice Address - Street 1:107 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:SARANAC
Practice Address - State:MI
Practice Address - Zip Code:48881-5121
Practice Address - Country:US
Practice Address - Phone:616-642-9408
Practice Address - Fax:616-642-6940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health