NPIMap

Organization Active NPI

Spectrum Health Hospitals

Doing business as Corewell Health Grand Rapids Hospitals Retail Pharmacy

  • Community/Retail Pharmacy
  • Grand Rapids, MI
National Provider Identifier
1144354671
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301003540 Issued in MI
Legal business name
SPECTRUM HEALTH HOSPITALS
Doing business as
Corewell Health Grand Rapids Hospitals Retail Pharmacy
Practice address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone
(616) 391-0567
Fax
(616) 391-1083
NPI assigned
Mar 15, 2007
Last updated
Jul 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hardik Dalal
Title
SVP, Finance
Phone
(616) 486-6790

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301003540 MI Primary

Addresses

Primary practice location

100 Michigan St NE
Grand Rapids, MI 49503-2560

Mailing address

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (616) 391-9267

Other identifiers 2

IdentifierTypeStateIssuer
2342210MedicaidMI
2040047OtherPK

Other names 1

  • Corewell Health Grand Rapids Hospitals Retail Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grand Rapids Pediatrics87 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1144354671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-9267",
            "fax_number": "616-391-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-0567",
            "fax_number": "616-391-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "DALAL",
        "authorized_official_first_name": "HARDIK",
        "authorized_official_title_or_position": "SVP, FINANCE",
        "authorized_official_telephone_number": "616-486-6790"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301003540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2342210",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2040047",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Grand Rapids Hospitals Retail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.