# LAKELAND COMMUNITY HOSPITAL WATERVLIET

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COREWELL HEALTH
- **Other names:** Corewell Health Watervliet Hospital Primary Care - Coloma
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1083710701
- **Legal business name:** COREWELL HEALTH
- **Authorized official:** MATT COX (CFO)
- **Authorized official phone:** (616) 391-0780

## Contact information

- **Practice address:** 6701 PAW PAW AVE, COLOMA, MI 49038-9519
- **Practice address phone:** (269) 468-6430
- **Practice address fax:** (269) 468-0013
- **Mailing address:** 400 MEDICAL PARK DRIVE, WATERVLIET, MI 49098
- **Mailing address phone:** (269) 463-2448
- **Mailing address fax:** (269) 463-5351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 04/01/2023