Organization
LAKELAND COMMUNITY HOSPITAL WATERVLIET
Active
Parent organization
COREWELL HEALTH
Other names
Corewell Health Watervliet Hospital Primary Care - Hartford
Organization subpart
Yes
Provider details
NPI number
Legal business name
COREWELL HEALTH
Authorized official
MATTHEW COX (CFO)
(616) 915-3777
Entity
Organization
Contact information
Practice address
525 S CENTER ST, HARTFORD, MI 49057-1362
(269) 621-4063
(269) 621-9972
Mailing address
400 MEDICAL PARK DRIVE, WATERVLIET, MI 49098
(269) 463-2448
(269) 463-5351
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700A160280
BCBSM
MI
Enumeration date
09/16/2006
Last updated
04/01/2023
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