Spectrum Health- Lake Drive Surgery Center
LBN: Spectrum Health
Spectrum Health- Lake Drive Surgery Center is an health care organization with primary practice located at 4069 Lake Dr Se Suite 210, Grand Rapids MI 49546-8816. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Ambulatory Surgical, Suppliers / Durable Medical Equipment & Medical Supplies. Ambulatory Health Care Facilities / Ambulatory Surgical is the primary health care specialty.
Spectrum Health can be contacted via phone (616) 285-1120, or through Welday, Dougals D via phone (616) 391-2525.
Contact Information
Primary practice address
4069 Lake Dr Se Suite 210
Grand Rapids MI 49546-8816
Phone: (616) 285-1120
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | 416835 | Michigan |
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1811983000 |
|---|---|
| LBN Legal business name | Spectrum Health |
| DBA Doing business as | Spectrum Health- Lake Drive Surgery Center |
| Authorized official | Welday, Dougals D |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Sep 22nd, 2005 |
| Last updated | Jul 29th, 2014 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811983000 | NPPES |
| Michigan | Other | 41034 | BLUE CROSS |
| Michigan | MEDICAID | 5170255 | BLUE CROSS |
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