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Organization
PENNOCK HOSPITAL
Active
Organization
PENNOCK HOSPITAL
Active
Parent organization
PENNOCK HOSPITAL
Other names
Corewell Health Pennock Hospital Family Medicine - Lake Odessa, Spectrum Health Pennock Family Medicine - Lake Odessa
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENNOCK HOSPITAL
Authorized official
JOHN SELLA (CONTROLLER)
(616) 802-0206
Entity
Organization
Contact information
Practice address
4294 LAUREL DR, LAKE ODESSA, MI 48849-8430
(616) 374-7660
(616) 374-0270
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/04/2015
Last updated
08/23/2023
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