# PENNOCK HOSPITAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PENNOCK HOSPITAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023340981
- **Legal business name:** PENNOCK HOSPITAL
- **Authorized official:** DEIDRE WELLER (CONTROLLER)
- **Authorized official phone:** (269) 945-1212

## Contact information

- **Practice address:** 1005 W GREEN ST, HASTINGS, MI 49058-1712
- **Practice address phone:** (269) 945-8080
- **Mailing address:** 100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/03/2010
- **Last updated:** 04/22/2016