ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.
Complete NPI Record 1063670453
Eyewear Supplier in Ironwood, MI

NPI Status: Active since June 02, 2008

Contact Information

E6112 E BLUFFVIEW RD
SUITE 102
IRONWOOD, MI
ZIP 49938
Phone: (906) 932-1436
Fax: (906) 932-1449

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Complete NPI Dataset

This page represents the complete record for NPI 1063670453. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1063670453
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: ASPIRUS GRAND VIEW
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 4
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: N10565 GRANDVIEW LN
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: IRONWOOD
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MI
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 499389622
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 9069321500
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 9069325630
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: E6112 E BLUFFVIEW RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: SUITE 102
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: IRONWOOD
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MI
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 499389367
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9069321436
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9069321449
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/2/2008
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 6/7/2024
The date that a record was last updated or changed.
Authorized Official Last Name: YANG
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: JERRY
The first name of the authorized official.
Authorized Official Middle Name: M
The middle name of the authorized official.
Authorized Official Title or Position: SVP & CHIEF FINANCIAL OFFICER
The title or position of the authorized official.
Authorized Official Telephone Number: 7158472526
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 152W00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 332H00000X
Healthcare Provider Primary Taxonomy Switch 2: Y
Is Organization Subpart: N
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 6/7/2024