# PENNOCK HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PENNOCK HOSPITAL
- **Other names:** Spectrum Health Pennock Family Medicine - Middleville, Corewell Health Pennock Hospital Family Medicine - Middleville
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1013453760
- **Legal business name:** PENNOCK HOSPITAL
- **Authorized official:** JOHN SELLA (CONTROLLER)
- **Authorized official phone:** (616) 802-0206

## Contact information

- **Practice address:** 490 EDWARD ST, MIDDLEVILLE, MI 49333-9131
- **Practice address phone:** (269) 795-4434
- **Practice address fax:** (269) 795-4271
- **Mailing address:** 100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/18/2017
- **Last updated:** 08/23/2023