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Organization

LAKELAND COMMUNITY HOSPITAL WATERVLIET

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

Provider details

NPI number
Legal business name
COREWELL HEALTH
Authorized official
MATT COX (CFO)
(616) 391-0780
Entity
Organization

Contact information

Practice address
6701 PAW PAW AVE, COLOMA, MI 49038-9519
(269) 468-6430
(269) 468-0013
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
700A110160
BCBSM
MI
Enumeration date
09/16/2006
Last updated
04/01/2023
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