Organization
PENNOCK HOSPITAL
Active
Parent organization
PENNOCK HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENNOCK HOSPITAL
Authorized official
DEIDRE WELLER (CONTROLLER)
(269) 945-1212
Entity
Organization
Contact information
Practice address
1005 W GREEN ST, HASTINGS, MI 49058-1712
(269) 948-8411
(269) 948-9874
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
06/07/2011
Last updated
04/22/2016
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